老年多发性骨髓瘤诊疗BLOOD2011.doc

From by on October 11, 2010. For personal use only. 2010 116: 2215-2223 Prepublished online Jul 19, 2010; doi:10.1182/blood-2009-10-163329 How I treat elderly patients with myeloma Jayesh Mehta, Michele Cavo and Seema Singhal Updated information and services can be found at: /cgi/content/full/116/13/2215 Articles on similar topics may be found in the following Blood collections: . How I Treat (50 articles) . Free Research Articles (991 articles) . Lymphoid Neoplasia (506 articles) Information about reproducing this article in parts or in its entirety may be found online at: /misc/rights.dtl#repub_requests Information about ordering reprints may be found online at: /misc/rights.dtl#reprints Information about subscriptions and ASH membership may be found online at: /subscriptions/index.dtl Blood (print ISSN 0006-4971, online ISSN 1528-0020), is published semimonthly by the American Society of Hematology, 1900 M St, NW, Suite 200, Washington Copyright 2007 by The American Society of Hematology; all rights reserved.  From by on October 11, 2010. For personal use only. How I treat How I treat elderly patients with myeloma Jayesh Mehta,1 Michele Cavo,2 and Seema Singhal1 1Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; and 2Sera`gnoli Institute of Hematology, Bologna University, School of Medicine, Bologna, Italy The clinical approach to older patients with myeloma has to be modified to take into account comorbidities and the likelihood of higher treatment-related toxicity. Individualization of management and adequate supportive therapy are important to obtain the best response while minimizing ad- Introduction verse effects. Corticosteroids, novel agents, conventional cytotoxic agents, and high-dose chemotherapy with auto- transplantation (modalities used in younger patients) are also used in older patients, alt