Clinical research in older adults with hematologic malignancies: Opportunities for alignment in the Veterans Affairs

Semin Oncol. 2019 Aug-Oct;46(4-5):341-345. doi: 10.1053/j.seminoncol.2019.09.001. Epub 2019 Oct 1.

Abstract

Management of hematologic malignancies in older patients is complex and, with recent and anticipated trends in demographics, increasingly common. As a large, nationally integrated medical system the Veterans Affairs has the potential to lead in research to benefit these patients. In this review we describe the evolving treatment paradigms of hematologic malignancies and how they are best fit with older patients through comprehensive evaluation of key vulnerabilities. We also discuss optimization of supportive care and navigation services to target identified risks and challenges aimed at ameliorating the patient's burden of cancer and treatment. Lastly, we discuss opportunities in design of prospective clinical trials to better align with real-world cases, thereby expanding enrollment of and applicability to older patients with hematologic malignancies.

Keywords: Clinical research; Geriatric; Hematologic malignancies; Veterans Affairs.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Biomedical Research* / statistics & numerical data
  • Clinical Trials as Topic
  • Disease Management
  • Female
  • Geriatric Assessment*
  • Hematologic Neoplasms / diagnosis
  • Hematologic Neoplasms / epidemiology*
  • Hematologic Neoplasms / therapy
  • Humans
  • Male
  • United States / epidemiology
  • Veterans Health* / statistics & numerical data
  • Veterans*