Despite the greater use of autologous transplant for multiple myeloma and allogeneic transplant for AML, significant underuse persists. A geriatric assessment is a multidimensional tool to assess physiologic reserve and can be used to assess fitness for transplant. Aging biomarkers paired with geriatric metrics may be a novel method to assess frailty and gauge risk of treatment toxicity in the future. Hematopoietic cell transplant outcomes can achieve favorable disease-free survival rate in older adults both in myeloma and AML.