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Related Concept Videos

Drug Dosing: Geriatric Patients01:15

Drug Dosing: Geriatric Patients

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Elderly individuals encompass a diverse population with varying degrees of age-related physiological changes. Defining the elderly presents challenges, as the geriatric population is often arbitrarily categorized as individuals older than 65. However, many individuals in this group lead active and healthy lives, with an increasing number surpassing 85 years and falling into the older elderly category. Physiological changes associated with aging impact performance capacity and homeostatic...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Absorption01:22

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As individuals age, their body's physiology evolves, affecting drug pharmacokinetics. The most apparent changes occur in the gastrointestinal tract, where an increase in gastric pH, a delay in gastric emptying, and a reduction in gastrointestinal motility are observed. Remarkably, these changes do not substantially modify the absorption of orally administered drugs, particularly those absorbed via passive diffusion.Transdermal drug delivery emerges as a highly viable method for older adults due...
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Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution01:00

Pharmacokinetics in Geriatric Patients: Effect of Age on Drug Distribution

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Drug distribution in the human body is influenced by several factors, including plasma protein concentration, body composition, blood flow, tissue-protein concentration, and tissue fluid pH. Among these, changes in plasma protein concentration and body composition due to aging significantly affect how drugs are distributed within the body. Specifically, aging is associated with a decrease in albumin levels by about 10% and an increase in α1-acid glycoprotein levels. These alterations are...
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Cancer is the second leading cause of death in the United States. A cancer cell is genetically unstable and hence can mutate faster. They can also modify their microenvironment and escape immune surveillance. The difficulties in treating cancer are further compounded by the emergence of rapid resistance to anticancer drugs. The most common ways to attain resistance in cancer cells include alteration in drug transport and metabolism, modification of drug target, elevated DNA damage response, or...
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Pharmacodynamics in Geriatric Patients: Effects of Age01:27

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Age-related pharmacokinetic changes are extensively documented, but understanding age-related pharmacodynamic alterations is relatively limited. This knowledge gap can be partly attributed to the complexity of developing appropriate measures of drug responses compared to bioanalytical methods for determining drug concentrations.Most information regarding age-related differences in human pharmacodynamics originates from cross-sectional studies. However, these studies assume that observed mean...
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Primary Lymphoid Organs01:16

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Primary lymphoid organs are pivotal in the formation, development, and maturation of lymphocytes, the white blood cells that serve as the backbone of our immune system. This crucial function underscores their fundamental role in maintaining our overall health and immunity. The two primary lymphoid organs of prime importance are the red bone marrow and the thymus.
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Diffuse Large B-Cell Lymphoma in the Elderly: Current Approaches.

Pamela Allen1

  • 1Winship Cancer institute of Emory University, 1365 Clifton Rd. NE, Suite 4000, Atlanta, GA, 30030, USA. pallen5@emory.edu.

Current Oncology Reports
|August 23, 2020
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Summary
This summary is machine-generated.

Older adults with diffuse large B-cell lymphoma (DLBCL) can be treated effectively with R-CHOP chemotherapy. Comprehensive geriatric assessment (CGA) helps tailor treatment for older patients, considering fitness and comorbidities.

Keywords:
AnthracyclineComprehensive geriatric assessmentDiffuse large B-cell lymphomaElderlyFrailOlder

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Area of Science:

  • Geriatric oncology
  • Hematologic malignancies
  • Lymphoma research

Background:

  • Older patients with diffuse large B-cell lymphoma (DLBCL) often have comorbidities impacting treatment tolerance.
  • Chemotherapy-related toxicity is a significant concern in elderly populations, particularly those identified as unfit or frail via comprehensive geriatric assessment (CGA).

Purpose of the Study:

  • To review the challenges and considerations for treating older patients with DLBCL.
  • To emphasize the role of CGA in optimizing treatment strategies for elderly DLBCL patients.

Main Methods:

  • Review of current literature on DLBCL treatment in older adults.
  • Analysis of the impact of comprehensive geriatric assessment (CGA) on treatment outcomes and toxicity.
  • Evaluation of standard chemotherapy regimens like R-CHOP in the elderly population.

Main Results:

  • Non-anthracycline chemotherapy is linked to poorer outcomes in both fit and unfit older patients.
  • A substantial number of older patients with DLBCL can achieve cure with standard R-CHOP chemotherapy.
  • CGA is crucial for assessing frailty, function, and comorbidities to guide initial therapy decisions.

Conclusions:

  • Comprehensive geriatric assessment (CGA) is vital for personalized treatment selection in older DLBCL patients.
  • Standard R-CHOP chemotherapy remains a viable and potentially curative option for many elderly individuals with DLBCL.
  • Tailoring therapy based on CGA can mitigate risks and improve outcomes for older adults undergoing DLBCL treatment.