Richard M. Stone, MD
A plethora of additional agents has given physicians more options for the treatment of older patients with acute myeloid leukemia (AML), explained Richard M. Stone, MD, although the optimal combinations and settings have yet to be discerned.
, Stone, who is also a professor of medicine at Harvard Medical School, discussed the therapeutic landscape for elderly patients with AML.
OncLive: How has the management of elderly patients with AML evolved in recent years?
: Thanks to the amazing number of newly FDA-approved drugs in AML, we have new options for older patients with the disease. We’ve seen the impact of genetics on prognosis and maybe even choice of therapy in certain cases.
Before we get to the new drugs, I want to make sure that people realize that there are different ways to assess the patient and the disease right now. In terms of patient assessment, we have to be good communicators and make sure we transmit what we know to the patient and their family. These are very stressed patients who can’t really hear what we say, so we have to avoid medical jargon when possible. Patients inflate what we tell them because the devastating news about their leukemia is hard to put into one’s own psyche.
Could you elaborate on patient assessment?
Patient assessment includes more than just performance status or whether we think they’re fit or unfit. A lot of research led by the late Arti Hurria, MD, of City of Hope, used something called the geriatric assessment scale. That may be better than [another test] that looks at the patient’s ECOG performance status or Karnofsky scales to assess their fitness for chemotherapy. Preliminary work has shown that the geriatric assessment, which is a battery of questions about social functioning, ability to do tasks, and physical tests, can predict a patient’s likelihood of success or failure with chemotherapy.
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