Optimal management of elderly patients with myeloma.

Many advances have been made in the treatment of patients with multiple myeloma including elderly subjects. The introduction of novel agents, such as thalidomide, lenalidomide, bortezomib, have revolutionized the treatment paradigm of this neoplasm, and second-generation molecules are currently being tested to offer patients a wider variety of treatment options and to improve outcome. The efficacy of a regimen should be carefully balanced against its toxicity profile. Elderly patients are particularly susceptible to adverse events that may lead to early treatment discontinuation. Thus, a more accurate distinction within the elderly population and a more appropriate treatment allocation is necessary. Here we describe the major and more recent treatment options available today for elderly patients with multiple myeloma.