Michael A. Kolodziej, MD

Emerging as one of the many pieces to the puzzle is the adoption of pathways based on evidence-based medicine (EBM). It has long been theorized that the use of standardized care models not only improves the quality of care, but also reduces costs and makes costs more predictable.

Oncology costs have become unaffordable for our healthcare system. Increasing at a rate of more than 15% per year, costs for treating cancer patients are far outpacing inflation and other healthcare costs.

Hematopoietic stem cell (HSC) transplantation may improve outcomes of patients with hematologic malignancies not curable with conventional therapies. In some clinical settings, transplantation represents the only curative option. The feasibility and efficacy of this approach in older patients are undefined, since this population has been excluded from nearly all clinical trials. Advances in supportive care, HSC harvesting, and safer conditioning regimens have made this therapy available to patients well into their 6th and 7th decades of life. Recent evidence suggests that elderly patients with good performance status and no comorbidities could, in fact, not only survive the transplant with reasonable risk, but also benefit in the same measure as younger patients.