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Management of multiple myeloma in older people

Published online by Cambridge University Press:  11 August 2014

E Bolaños ,
B Iñigo ,
C Benavente  and
R Martínez
E Bolaños
Affiliation:
Department of Haematology, Hospital Clinico San Carlos, Madrid, Spain
B Iñigo*
Affiliation:
Department of Haematology, Hospital Clinico San Carlos, Madrid, Spain
C Benavente
Affiliation:
Department of Haematology, Hospital Clinico San Carlos, Madrid, Spain
R Martínez
Affiliation:
Department of Haematology, Hospital Clinico San Carlos, Madrid, Spain
*
Address for correspondence: Dr Belen Iñigo-Rodriguez, Department of Haematology, Hospital Clinico San Carlos, Madrid, Spain. Email: belen.inigo@gmail.com
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Summary

Multiple myeloma is a neoplastic proliferation of a plasma cell clone that produces a monoclonal immunoglobulin. It is one of the most common haematological malignancies and the incidence increases with age, with a median age at diagnosis of 65–70 years. The diagnosis of multiple myeloma requires the presence of ≥10% plasma cells in the bone marrow and an M-protein in serum and/or urine. Cytogenetic status, serum β2-microglobulin and response to therapy are the key prognostic factors. Treatment is necessary for the patient diagnosed with symptomatic multiple myeloma, with organ damage. Patients older than 65 years are ineligible for autologous transplantation. The introduction of novel agents, such as thalidomide, bortezomib and lenalidomide, have changed the management of myeloma and extended overall survival. However, in older patients the results are not as satisfactory and treatment strategies have to be individualized to improve tolerability and optimize efficacy.

Keywords

monoclonal gammapathymultiple myelomaolder patientsupportive carebortezomiblenalidomidethalidomide
Type
Review Article
Information
Reviews in Clinical Gerontology , Volume 24 , Issue 3 , August 2014 , pp. 173 - 181
Copyright
Copyright © Cambridge University Press 2014 

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