open access

Vol 10, No 5 (2014)
Review paper
Published online: 2014-11-18
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Complications in the systemic treatment in elderly patients. Neutropenia as limiting factor

Jakub Kucharz, Anna Michałowska-Kaczmarczyk, Roman Maria Herman, Krzysztof Krzemieniecki
Onkol. Prak. Klin 2014;10(5):253-257.

open access

Vol 10, No 5 (2014)
REVIEW ARTICLES
Published online: 2014-11-18

Abstract

The ageing of the population, increasing life expectancy and cancer morbidity make the systemic treatment of patients over the age of 65 common issue in medical oncology. Older patients constitute a very heterogeneous group due to the differences in their general condition, organ reserves, comorbidities and the polypharmacy as its consequence. In the treatment planning in geriatric oncology it is crucial to select those patients who are able to tolerate intensive treatment e.g. induction chemotherapy or adjuvant treatment (in those with expected longsurvival) and patients in whom less aggressive treatment or best supportive care is the most beneficial approach. The ageing process has been associated with changes in pharmacodynamics and pharmacokinetics of the cancer medications resulting in their higher toxicity in elderly. Myelotoxicity is very common and older age is one of the most important risk factors for severe neutropenia and febrile neutropenia. It has been exhibited that comorbid conditions in elderly independently increase the risk of febrile neutropenia. It should also be noticed that in caseof curative treatment myelosupression and its complications may result in chemotherapy dose reductions, treatment interruptions, decreasing overall treatment efficacy. For these reasons the assesment of risk of myelotoxicity and its complications as well as the appropiate use of granulocyte-colony stimulating factors in elderly patientsis very important in clinical practice.

Abstract

The ageing of the population, increasing life expectancy and cancer morbidity make the systemic treatment of patients over the age of 65 common issue in medical oncology. Older patients constitute a very heterogeneous group due to the differences in their general condition, organ reserves, comorbidities and the polypharmacy as its consequence. In the treatment planning in geriatric oncology it is crucial to select those patients who are able to tolerate intensive treatment e.g. induction chemotherapy or adjuvant treatment (in those with expected longsurvival) and patients in whom less aggressive treatment or best supportive care is the most beneficial approach. The ageing process has been associated with changes in pharmacodynamics and pharmacokinetics of the cancer medications resulting in their higher toxicity in elderly. Myelotoxicity is very common and older age is one of the most important risk factors for severe neutropenia and febrile neutropenia. It has been exhibited that comorbid conditions in elderly independently increase the risk of febrile neutropenia. It should also be noticed that in caseof curative treatment myelosupression and its complications may result in chemotherapy dose reductions, treatment interruptions, decreasing overall treatment efficacy. For these reasons the assesment of risk of myelotoxicity and its complications as well as the appropiate use of granulocyte-colony stimulating factors in elderly patientsis very important in clinical practice.

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Keywords

systemic treatment, elderly, neutropenia

About this article
Title

Complications in the systemic treatment in elderly patients. Neutropenia as limiting factor

Journal

Oncology in Clinical Practice

Issue

Vol 10, No 5 (2014)

Article type

Review paper

Pages

253-257

Published online

2014-11-18

Bibliographic record

Onkol. Prak. Klin 2014;10(5):253-257.

Keywords

systemic treatment
elderly
neutropenia

Authors

Jakub Kucharz
Anna Michałowska-Kaczmarczyk
Roman Maria Herman
Krzysztof Krzemieniecki

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