The term myeloproliferative disorders (MPDs) describes a group of conditions in which an intrinsic stem cell defect is present in the bone marrow. This leads to hypercellularity in one or more of the myeloid cell lines (red blood cells, platelets, granulocytes and their precursors), or increased bone marrow fibrosis. MPDs are rare; combined annual incidence is 6 per 100,000.

MPDs may present in asymptomatic patients as an incidental finding, or may be associated with constitutional features such as weight loss, sweats or lethargy. Splenomegaly is common but lymphadenopathy is not a feature. The most significant complications are: arterial thrombosis, venous thrombosis, secondary marrow fibrosis and transformation to acute myeloblastic leukaemia (AML). Treatment aims to reduce the risk of such complications.

Recent advances in the understanding of the pathogenesis of these disorders have radically changed the approach to the diagnosis of MPD and are the focus of new treatment developments.

The incidence of most haematological malignancies increases with age. Given that those aged >65 years represent the fastest growing segment of Western populations, these cancers may commonly present to medical teams with an interest in older patients. Over the last 20 years there have been dramatic improvements in the outlook for patients diagnosed with haematological cancers, but there is evidence that many of these improvements have been restricted to younger patients. It is therefore important that older patients with haematological malignancies are rapidly diagnosed and promptly treated with the best available therapies. Clinical trials that specifically encompass older patients are clearly important. In this review, the presentation and management of common haematological malignancies will be discussed, including myelodysplasia, acute leukaemia, lymphoproliferative disorders and myeloma.