Multiple myeloma is a disease typical of the elderly, and, because of the increase in life expectancy
of the general population, its incidence is expected to
grow in the future. Elderly patients represent
a particular challenge due to their marked hete
rogeneity. Many new and highly effective drugs
have been introduced in the last few years, and resu
lts from clinical trials are promising. Besides
the availability of novel agents, a careful evaluation of elderly patients showed to be a key factor for
the success of therapy. A geriatric assessment is a valid strategy to better stratify patients. In
particular, different scores are available today to appropriately assess elderly patients and define
their fitness/frailty status. The choice of treatm
ent – transplantation, triplets, doublets, or reduced-
dose therapies including novel agents – should depend on the patient’s fitness status (fit,
intermediate-fit or frail). Second-generation no
vel agents have also been evaluated as salvage
therapy in the elderly, and these new agents certai
nly represent a further step forward in the
treatment armamentarium for elderly patients with multiple myeloma.