Chronic lymphocytic leukaemia: treating the elderly patient

Chronic lymphocytic leukaemia results from an increase in circulating levels of lymphocytes. This causes a reduction in erythrocytes and other blood components.

Chronic lymphocytic leukaemia (CLL) is more common over the age of 65, when the incidence rate rises to 22-30 per 100,000. However, most clinical trials do not usually include patients with CLL from this age group. Elderly patients with CLL present with a range of comorbidities that must be taken into account when assessing and considering management of CLL, owing to the impact of comorbidities on survival. According to the German CLL Study Group, which used the Cumulative Illness Rating Scale to measure comorbidity in elderly patients with CLL in its clinical trials, treatment decisions should be made on a case-by-case basis. The researchers were investigating dose-reduced purine analogue-based combination therapies with or without immunotherapy. Usually, non-fit patients with CLL are treated with chlorambucil.

Reference
Eichhorst B, Goede V, Hallek M. Treatment of elderly patients with chronic lymphocytic leukemia. Leuk Lymphoma 2009; Feb 5: 1-8.

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