My recommendations for decision making in management of older patients with ALL
| General risk assessment . | Aim . |
|---|---|
| Structured comorbidity assessment | • To estimate the risk of potential complications and specifically required supportive care and to assess co-medications |
| Shortened comprehensive geriatric assessment | • To identify patients without relevant deficits as candidates for a moderate intensive chemotherapy (fit) up to age 70 to 75 years |
| • To identify patients with relevant deficits for a more detailed assessment to decide on possible strategies to improve the status (unfit) | |
| • To identify patients for standardized palliative care as best option (frail) | |
| Life expectancy assessment | • To make an assumption on the individual risk-benefit ratio based on life-table data of a population together with patient characteristics |
| Disease-related risk assessment based on comprehensive leukemia diagnostics | • To identify clinical or biologic factors and assess availability of targeted therapies or new drugs |
| • To estimate the individual chances of response and survival | |
| Patients perspectives | • To understand patients’ wishes and expectations |
| Treatment selection | • To select, whenever possible, standardized treatments, report patients to registries, and recruit to ongoing trials |
| Comprehensive informed consent | • To explain prognosis, treatment recommendations, justification, and alternatives to patients and relatives; if no reasonable treatment can be offered, this has to be explained as well |
| • To consider the perspectives of relatives who may become caregivers | |
| • To present options for participation in clinical trials, including referral to other hospitals |
| General risk assessment . | Aim . |
|---|---|
| Structured comorbidity assessment | • To estimate the risk of potential complications and specifically required supportive care and to assess co-medications |
| Shortened comprehensive geriatric assessment | • To identify patients without relevant deficits as candidates for a moderate intensive chemotherapy (fit) up to age 70 to 75 years |
| • To identify patients with relevant deficits for a more detailed assessment to decide on possible strategies to improve the status (unfit) | |
| • To identify patients for standardized palliative care as best option (frail) | |
| Life expectancy assessment | • To make an assumption on the individual risk-benefit ratio based on life-table data of a population together with patient characteristics |
| Disease-related risk assessment based on comprehensive leukemia diagnostics | • To identify clinical or biologic factors and assess availability of targeted therapies or new drugs |
| • To estimate the individual chances of response and survival | |
| Patients perspectives | • To understand patients’ wishes and expectations |
| Treatment selection | • To select, whenever possible, standardized treatments, report patients to registries, and recruit to ongoing trials |
| Comprehensive informed consent | • To explain prognosis, treatment recommendations, justification, and alternatives to patients and relatives; if no reasonable treatment can be offered, this has to be explained as well |
| • To consider the perspectives of relatives who may become caregivers | |
| • To present options for participation in clinical trials, including referral to other hospitals |