Hematologic Disorders

Hematologic disorders are a diverse group of malignant and nonmalignant conditions arising from the blood and other hematopoietic sources. Many of the malignant disorders (myelodysplastic syndrome, multiple myeloma, and myeloproliferative neoplasms) are clonal in nature and occur with increasing frequency in older adults (aged ≥65 years). The prevalence of anemia also increases with advancing age. Importantly for older adults, the causes of anemia are many, resulting from chronic diseases, inflammatory conditions, and nutritional deficiencies, which may coexist therefore making the diagnosis difficult. As the global number of older adults continues to rapidly expand, the prevalence and incidence of hematologic disorders are also expected to increase. Thus, there is a need to refine the approaches to diagnosis and management of hematologic disorders to include strategies which account for the intersection of aging and hematology. Such an approach would involve assessment of patient fitness through the use of geriatric assessments, which may then be used to tailor an appropriate individualized management plan for an older adult. Furthermore, such an approach accounts for the heterogeneity of aging while incorporating patient preferences. Use of a personalized approach for the management of hematologic disorders could improve disease-related outcomes, especially for those considered less fit or frail, while minimizing treatment-related toxicities and preserving quality-of-life.