Although age may reduce the physiologic reserve of many systems, elderly patients with good performance status may receive chemotherapy without undue toxicity. Both survival and quality of life may be improved by treatment of responsive neoplasms, such as acute leukemia, multiple myeloma, small cell cancer of the lung, lymphomas and breast cancer. Age-related decrements in glomerular filtration rate and cardiac reserve suggest that doses of renally excreted drugs and cardiotoxic anthracyclines should be reduced in the elderly.