Department of Haematology, University College London Hospitals, 250 Euston Road, London, UK; Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RJ, UK.
Department of Haematology, Guy's and St. Thomas' NHS Foundation Trust, Great Maze Pond, London, SE1 9RJ, UK.
Best Pract Res Clin Haematol. 2022 Jun;35(2):101371. doi: 10.1016/j.beha.2022.101371. Epub 2022 Aug 5.
Over the last decade, we have witnessed a massive increase in available clinical agents, both in the clinical trial setting and following commercial use approval, directed to reduced life expectancy as well as the considerable symptom, splenic and anaemia burden associated with myelofibrosis. Given the median age of onset of the disease, coupled with an ageing population globally, we will be caring for an increasingly aged myelofibrosis cohort in future years. We will need to adapt our approach, emphasizing the holistic management of the older individual with myelofibrosis accordingly. Out with the pharmacological management of the disease, consideration needs to be given to interventions based on concurrent illness, comprehensive geriatric assessments, frailty, polypharmacy and drug-drug interactions, nutritional issues, psychological concerns (depression, anxiety or distress), cognitive decline and social/economic aspects. Within this review, we summarise available data addressing these issues, outline knowledge gaps and suggest a summative and holistic approach to the older individual with myelofibrosis.
在过去的十年中，我们见证了大量可供选择的临床药物的出现，无论是在临床试验环境中还是在商业使用批准后，这些药物都旨在降低预期寿命，以及与骨髓纤维化相关的大量症状、脾脏和贫血负担。鉴于该疾病的发病中位年龄，加上全球人口老龄化，我们将在未来几年照顾越来越多的老年骨髓纤维化患者群体。我们需要调整我们的方法，相应地强调对老年骨髓纤维化个体的整体管理。除了对疾病进行药物治疗外，还需要考虑基于合并疾病、全面老年评估、虚弱、多种药物并用和药物相互作用、营养问题、心理问题（抑郁、焦虑或痛苦）、认知能力下降以及社会/经济方面的干预措施。在本次综述中，我们总结了有关这些问题的现有数据，概述了知识空白，并对老年骨髓纤维化患者提出了综合全面的方法。
