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Personalized treatment strategies for elderly patients with myelodysplastic syndromes
Joint Event on 15th EUROPEAN PATHOLOGY CONGRESS & 14th International Conference on LEUKEMIA AND HEMATOLOGIC ONCOLOGY
Roberto Castelli
University of Milan, Italy
Keynote: J Clin Exp Pathol
DOI:
Abstract
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematopoietic disorders characterized by ineffective hematopoiesis and peripheral cytopenia and their possible transformation into acute myeloid leukemia (AML). They typically affect the elderly but when making treatment decisions, considering chronological age may be insufficient because it poorly correlates with patient frailty. The challenge is to select the optimal treatment in these patients by balancing efficacy and toxicity. We will discuss the rationale for and methods of personalizing the treatment of elderly MDS patients. Decisions concerning treatment strategies for elderly MDS patients should be made after assessing their frailty on the basis of a geriatric assessment and an estimation of age-adjusted life expectancy. We suggest that all elderly MDS patients should undergo a timed up and go test (TUGT) as a preliminary means of identifying frail patients and that all non-frail patients should then undergo a comprehensive geriatric assessment (CGA) in order to distinguish fit and pre-frail patients. Fit patients should receive standard dose treatment, pre-frail patients should receive individualized therapy and frail patients should receive symptom-related therapy. A repeated CGA may be useful to evaluate the hematological, cognitive and socio-relational effects of MDS treatment.Biography
Roberto Castelli has obtained his degree in Medicine from University of Milan and then specialization in Internal Medicine and Hematology from University of Milan. In addition, he obtained PhD in Clinical Methodology from University of Milan. He worked as Hematologist at Ospedale Maggiore di Milano University of Milan and at University Hospital Ospedale Luigi Sacco. He is involved in malignant and non-malignant hematological disease focusing on myelodysplastic syndromes, acute and chronic leukemias and myeloproliferative neoplasms. He is responsible of Leukemia Section at Ospedale Luigi Sacco University of Milan.
E-mail: roberto.castelli@unimi.it
