Diagnostic difficulties and differences in the course of haematologic diseases in old age

Influence of the aging process on the haematopoietic system is complex and multifactorial. Basic haematopoesis is preserved during the whole life. However, the recent years’ research has shown that the aging process influences changes in the haematopoietic system. The number of active marrow cells undergoes significant decrease, as they are replaced by connective and fibrous tissue. Along with age, there are also changes in the haematopoietic microenvironment, which regulates the process of haematopoesis, inter alia producing cytokines, which are survival and growth factors, regulating the process of apoptosis. Considering complex, physiopathologic senile changes, the incidence of some blood diseases increases in old age. The most frequent haematopoietic system diseases at this stage of life are anaemias of various aetiology, myeloproliferative and lymphoproliferative syndromes and acquired haemorrhagic diathesis. Diagnostic process as well as treatment of those diseases demonstrate a number of peculiarities in old age. The really important procedural element is a case-by-case approach to the patient. Decisions concerning treatment of elderly patients should be based on the geriatric assessment and all the factors which may influence effectiveness of the therapy should be taken into account.