Hematopoietic growth factors in older cancer patients

Abstract

Approximately 80% of all malignancies arise in individuals over age 60 [1]. While evidence suggests that chemosensitivity of certain neoplasms may diminish with increasing age [2, 3], similar benefits from systemic chemotherapy have been observed regardless of age, provided adequate treatment doses are employed [4-8]. Nevertheless, older age remains an independent risk factor for substantial reductions in chemotherapy relative dose intensity (RDI) [9], potentially resulting in compromised outcomes. Reduction in chemotherapy dosing for elderly patients is not entirely unfounded. Dose reductions occur largely in response to the established association between older age and hematologic toxicity, particularly febrile neutropenia. Neutropenic complications in elderly patients are associated with prolonged hospitalization and higher mortality among hospitalized patients [10]. Myeloid growth factors have been employed in the setting of chemotherapy use in order to mitigate the precipitous decline in white blood cells associated with many chemotherapeutic regimens. Administration of myeloid growth factors may accordingly facilitate the delivery of full doses of chemotherapy in order to optimize parameters of survival. A positive impact of quality of life can be observed, as well, when neutropenic complications and their associated risks are minimized. © 2011 Springer Science+Business Media, LLC.