Hematopoietic growth factors support in the elderly cancer patients treated with antiblastic chemotherapy

Maurizio Rupolo, Arben Lleshi, Bruno Cacopardo, Mariagrazia Michieli, Massimiliano Berretta

Research output: Contribution to journalArticle

Abstract

The 60% of tumors affected patients >65years of age and the future previsions are considering an amount of 70% after 2030. Elderly Patients present multiple comorbidity, polypharmacy, and disability. Geriatric assessment helps physicians to take the best therapeutic decisions. Clinical conditions influence efficacy and tolerability of chemotherapy. Prophylactic use of G-CSF after chemotherapy lowers the rate and length of severe neutropenia, and decreases the episodes of febrile neutropenia. Anemia is a hematologic condition associated with ageing, but is frequently associated to concomitant chronic disease. Stem cells display increasing resistance to erythropoietin in the elderly patients and this is connected with the onset of pro-inflammatory cytokines characteristic of this age. Anemia is a common adverse event in cancer patients receiving chemotherapy. Several of the symptoms associated with anemia, such as fatigue, syncope, palpitations and dyspnea, reduce patient activity and have a profound effect on the quality of life [QOL].Considering the unfit or frail status of elderly patient the at home use of peg-filgrastim and weekly or every three weekly erythropoietin administration should be preferred for this setting of patients that lack of specialized nursing care or facilities. Further studies, considering the several differences in health organizations in vary countries, should be held to state the real impact of the biosimilars in comparison to the long acting originators in the reduction of costs in this group of patients.

Original languageEnglish
Pages (from-to)1438-1443
Number of pages6
JournalAnti-Cancer Agents in Medicinal Chemistry
Volume13
Issue number9
DOIs
Publication statusPublished - 2013

Keywords

  • Anemia erythropoietin
  • Chemotherapy
  • Elderly
  • Geriatric assessment
  • Neutropenia
  • Peg-filgrastim
  • Pegfilgrastim
  • Pharmacoeconomics

ASJC Scopus subject areas

  • Cancer Research
  • Molecular Medicine
  • Pharmacology
  • Medicine(all)

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