Age and aging in blood disorders: multiple myeloma.

Viscoli C, et al. European guidelines for empirical antibacterial therapy for febrile neutropenic patients in the era of growing resistance: presentation and management of drug-induced agranulocytosis. Neutrophil mobilization via plerixafor-mediated CXCR4 inhibition arises from lung demargination and blockade of neutrophil homing to the bone marrow.onset neutropenia associated with rituximab therapy: evidence for a maturation arrest at the (pro)myelocyte stage of granu-lopoiesis. External quality assessment of human neutrophil antigen (HNA)-specific antibody detection and HNA genotyping from 2000 to 2012. Anagnostopoulos A, Papadaki T, et al. Activated T-lymphocytes with myelosuppressive properties in patients with chronic idiopathic neu-tropenia. Koutala H, et al. Impaired granulocytopoiesis in patients with chronic idiopathic neutropenia is associated with increased apoptosis of bone marrow myeloid progenitor cells. et al. Standardization of flow cytometry in myelodysplastic syndromes: a report from an international consortium and the European LeukemiaNet Working Group. Do new standards of care incorporating immunomodulatory agents and proteasome inhibitors benefit all elderly patients with multiple myeloma? Multiple myeloma (MM) accounts for 1% of all types of cancer and for 2% of all cancer deaths. These numbers are approximately 13% for all hematologic malignancies and 20% for hematologic malignancy-related deaths. 1,2 MM is a disease of the elderly reflected by a median age at diagnosis of approximately 70 years, with 35-40% of patients being older than 75 years. 3 The introduction of the immunomodulatory agents (IMiDs; thalidomide, lenalidomide and pomalidomide) and the proteasome inhibitors (PIs; bortezomib and carfil-zomib) has not only greatly improved the prognosis of younger patients with MM, also in elderly MM patients aged 65 years or over. The addition of bortezomib or thal-diomide to melphalan and prednisone (MP) improved overall survival (OS) by 13.3 and 6.6 months, respectively. Although the addition of lenalidomide to melphalan and prednisone did not improve OS, progression-free survival (PFS) significantly improved by 18 months, provided that maintenance therapy was given. 6 However, when considering the outcome as described in population-based registries , reflecting real-life situations, the elderly patients appear to benefit less. Recently, in the Italian and Dutch population-based registry (PBR), the overall survival of very old patients (≥75 years of age) was found to be similar over time, without any improvement in OS after the introduction of novel agents in 2006 2 (SG Verelst, personal communication , 2014). This lack of impact does not seem to be explained by a biologically different, more aggressive disease in the elderly. Although differences in …