To read a report from this conference in Italian click here

European haemato-oncologists met in Rome 19th-20th March to discuss the treatment of blood cancer in the elderly, with the aim of driving widespread change to ensure equality of care for everyone, whatever their chronological age. Elderly patients are currently under-treated in everyday clinical practice and under-represented in clinical trials. Both clinical and policy shifts are being discussed to tackle this problem The evidence that emerged from the meeting clearly indicated that doctors are guilty of 'ageism': elderly patients are being de-selected from active treatments and are being offered "less intensive treatments" which in some cases means no treatment at all. Elderly patients are considered those over 70, however when discussing treatment options for this group of patients doctors should consider the biological age of the patient and this can be partially estimated with a Comprehensive Geriatric Assessment (CGA). It was agreed that a CGA should be routinely performed to assess co-morbidities and the eligibility of the patient for intensive therapy.

While all agreed that elderly patients should be put into Clinical trials, the polling results from interactive questions during the major sessions clearly indicated that nearly 70% of 1100 delegates have never put an elderly patient into a clinical trial. We need to understand how to treat these patients and so we need the results of relevant clinical trials.

Of course not all patients will tolerate aggressive therapies and in these patients lower doses of should be considered and data suggest that excellent responses can still be achieved. Also evidence is mounting that maintenance therapy should also be offered to elderly patients who go into remission.

A series of novel agents were presented that are efficacious in elderly patients, many of these are less toxic that the traditional chemotherapic agents and may be better tolerated by the older individual. But again these patients have often been excluded from trials so there is no evidence base.

Finally the issue of support. It was noted that the patient is not being included in the therapeutic discussion, and this must change. The doctor must include the patient and their carers (if the patient wishes) in any decisions regarding therapy.

With over 50% of newly diagnosed cancers occurring in the over sixty-fives and the percentage of this population steadily increasing, we have a real challenge to improve this situation.