Age is no longer a therapeutic criterion in hematogeriatrics

Given that each time we reach old age with more health, hematologists have decided that chronological age is no longer the main therapeutic criterion, but rather that general condition, functionality, frailty, social support and the patient’s life goals, as agreed at the annual meeting of the Hematogeriatrics Group (GEHEG), of the Spanish Society of Hematology and Hemotherapy (SEHH), reference forum national approach to the elderly patient.

“Chronological age can no longer be the main therapeutic criterion in the field of health. Today the focus is on fragility, functionality and patient preferences. It is no longer enough to treat the disease; “it is essential not to forget the person,” said Dolly Fiallo, one of the coordinators of this edition and a hematologist at the Dr. Negrín Hospital in Las Palmas de Gran Canaria, who stressed that “Hematogeriatrics has ceased to be an emerging concept and has become a central axis of clinical practice,” according to the publication. Europe Press.

The SEHH, in the twelfth edition of its annual workshop, has the objective of “adapting therapeutic innovation to an increasingly long-lived and complex population”. The comprehensive geriatric assessment (VGI) makes it possible to evaluate the patient’s functional reserve, comorbidities, cognitive status, social support and life goals in order to have effective therapies, but also to know “who to administer them to and how to adapt them.” Specialists have stressed, at the same time, the need to consolidate “truly multidisciplinary teams.” Polypharmacy, undetected frailty, unequal access to geriatric specialists, lack of shared decision making or structured integration of geriatrics in some hospitals continue to be some of the challenges in this process.

#PressReleaseSEHH | The chronological age of the patient is no longer the main therapeutic criterion in Hematogeriatrics @hematogeriatria

+ information: https://t.co/PYJS3pWWFZ#hematogeriatrics #SEHHematology #hematology #fragility #functionality pic.twitter.com/0zgLeNDNNQ

— @sehh_es (@sehh_es) February 23, 2026

Older patient, a paradigm that is changing

Targeted and immunological therapies, in many cases without using conventional chemotherapy, are “changing the paradigm in the elderly patient.” The incorporation of oral drugs and less intensive regimens allow the disease to be controlled “with less toxicity” and facilitates outpatient treatments better adapted to people with greater fragility. Among the most relevant advances are BTK, BCL-2, FLT3, JAK or IDH inhibitors, immunotherapy with bispecific antibodies and, in selected cases, CAR-T therapies, as well as low-intensity, high-efficacy combinations. With these advances, patients who previously could only receive palliative treatments can be treated and “potentially curative strategies” can be opened.

However, andThese treatments can impact fragility, so evaluating the situation and intervening on “the detected deficits” is essential. In this sense, nutrition, physical exercise, deprescribing and prehabilitation and rehabilitation strategies are considered “essential tools to preserve quality of life and promote therapeutic success.” The objective of this ‘workshop’ is to increase the patient’s resilience through prehabilitation and rehabilitation strategies that improve “tolerance to treatment” and promote “functional recovery.”

Autonomy and mental sovereignty of the patient

This meeting has also addressed the relevance of neurorights in these increasingly complex treatments. To guarantee the autonomy and mental sovereignty of the patient, it is essential to carry out a systematic cognitive evaluation before the start of therapies and ensure adequate understanding of the informed consents. Furthermore, the early integration of palliative care in elderly hematological patients is beneficial to improve symptomatic control, facilitate advance planning of consensual decisions and contribute to the reduction of unnecessary hospitalizations, to promote more humanized care focused on quality of life.

The president of the GEHEG and hematologist at the Gregorio Marañón General University Hospital in Madrid, Mónica Ballesteros, has indicated that between Its priorities are “access to validated geriatric assessment scales and promoting recommendations on associated intervention measures”. Among the most relevant advances in recent years, Ballesteros has highlighted the creation of Hematogeriatric units or the integration of geriatricians or internists in hematology teams. However, its main challenge is to generate solid evidence on the impact of geriatric assessment on different hematological pathologies and its relationship with frailty.