Despite a high incidence of hematologic malignancies in older adults, available data indicate that there is disproportionately low representation of adults ≥65 years with hematologic malignancies (greater in patients ≥75 years) in clinical trials. Biological and clinical differences between older and younger adults and diversity within older patients necessitate adequate representation of the older subpopulation in hematologic malignancy trials. This would allow trial results to be generalizable and inform treatment decisions in the older patient population. Restrictive eligibility criteria may be barriers to adequate representation, as older adults do not typically meet these criteria. Efforts to broaden eligibility criteria in clinical trials have been proposed and may promote enrollment of a representative older population with hematologic malignancies. Collaboration among a diverse group of stakeholders will be needed to implement current proposals and evaluate their impact on increasing representation of older adults in trials evaluating therapies for hematologic malignancies.

尽管在老年人中血液系统恶性肿瘤的发生率很高，但现有数据表明，在临床试验中，≥65岁的成年人中血液系统恶性肿瘤的比例低得多（≥75岁的患者更大）。老年人和年轻人之间的生物学和临床差异以及老年患者的多样性需要在血液系统恶性肿瘤试验中充分表现出老年亚群。这将使试验结果具有普遍性，并为老年患者群体提供治疗决策依据。限制性的资格标准可能会阻碍获得足够代表的资格，因为老年人通常不符合这些标准。已经提出了扩大临床试验中的资格标准的努力，并且可能促进具有血液系统恶性肿瘤的代表性老年人群的注册。在评估血液恶性肿瘤疗法的试验中，将需要不同利益相关者之间的协作来实施当前的建议并评估其对增加老年人代表的影响。