At an expert panel discussion at the 13th Conference of the International Society of Geriatric Oncology (SIOG) in Copenhagen, Denmark, Prof Matti Aapro from University of Geneva, Switzerland, is joined by Dr Lodovico Balducci from Moffitt Cancer Centre, Florida, USA; Prof Mario Boccadoro from San Giovanni Hospital, Turin, Italy; and Prof Anders Österborg from Karolinska Institutet, Stockholm, Sweden, to discuss the management of older haematology patients and treatment guidelines for elderly patients with multiple myeloma and chronic lymphocytic leukaemia.
Dr Balducci underlines the message that anaemia in the elderly must not be overlooked, as it may not only indicate underlying disease but may itself lead to complications.
He discusses the difficulty in defining anaemia, especially in elderly women, as it has multiple causes. Prof Boccadoro highlights the need to look for the causes of a patient’s anaemia.
He also attributes the increased survival of myeloma patients over the last five to ten years, even the very old and frail, to new chemotherapy agents becoming available. However, a learning curve is needed to optimise treatment schedules, doses and routes of administration. Prof Boccadoro then discusses the positive results seen when multiple drugs are used to treat patients, but highlights the increased toxicity issues.
Prof Österborg discusses new emerging treatments for chronic lymphocytic leukaemia (CLL) and their potential to save lives where there is autoimmune haemolytic anaemia.
He speaks about the move away from chemotherapy to targeted therapy in the treatment of CLL. Prof Boccadoro highlights the differences between treating myeloma and CLL, and the role of chemotherapy in elderly myeloma patients. The panellists conclude that the elderly can have tolerable, effective treatment, but that expert care is needed.
This programme has been supported by an unrestricted educational grant from Janssen Pharmaceutica (A Johnson & Johnson Company)