Supportive Care in Older Lymphoma Patients to Reduce Toxicity and Preserve Quality of Life

SIMPLE SUMMARY: Lymphoproliferative disorders are commonly observed in the elderly population and usually their treatment can cause numerous side effects, loss of autonomy and impaired quality of life. The management of these patients, when a curative treatment is proposed, needs to be personalized according to subject, disease and treatment features. Nowadays, in order to reduce the impact of toxicities, supportive therapy is a crucial ally during the administration of chemo-immunotherapy. Particularly, the prevention of hematological and infectious complications, tumor lysis syndrome and cardiovascular and neurological events could lead not only to improved oncological outcomes but also to improved quality of life. ABSTRACT: The treatment paradigm in older patients with malignant hemopathies is the choice between an effective conservative treatment that preserves quality of life and an intensive, potentially curative treatment with more toxicities. For each patient, it is important to determine the risk/benefit ratio. The patient should be involved in the discussion, sufficiently informed and able to express himself and his expectations in terms of quality of life. However, this informed consent is conditioned by the ability of the patient to understand the risks and benefits of the treatment. Decline in quality of life is an important parameter for older patients with cancer and many prospective trials have now confirmed the impact of different side effects of treatment, such as recurrent hospitalization, loss of autonomy in daily activities, loss of contact with grandchildren and loss of cognitive functions. Interventions oriented to vulnerabilities detected in the older patients (by comprehensive geriatric assessment) and an optimal approach, including preventive measures to reduce treatment-related toxicity and mortality, are directly correlated to improvement in quality of life.