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Published on: November 26, 2018
Chronic Lymphocytic Leukemia in the Elderly: Epidemiology and Proposed Patient-Related Approach
Lodovico Balducci1, Dawn Dolan
1Senior Adult Oncology Program, Moffitt Cancer Center, Tampa, FL 33612, USA. Lodovico.Balducci@Moffitt.org.
Insights
Older adults with chronic lymphocytic leukemia (CLL) face treatment challenges. Geriatric assessment and new therapies can improve outcomes for elderly CLL patients.
Area of Science:
- Hematology
- Geriatrics
- Oncology
Background:
- Chronic lymphocytic leukemia (CLL) disproportionately affects the elderly, with most deaths occurring in individuals aged 65 and older.
- Aging-related comorbidities and functional decline complicate treatment efficacy in older CLL patients.
Purpose of the Study:
- To review current treatment guidelines and emerging therapies for CLL in older adults.
- To explore the role of physiological aging and geriatric assessment in managing CLL.
Main Methods:
- Systematic review of CLL epidemiology, treatment guidelines, and recent therapeutic advancements.
- Analysis of studies focusing on physiological aging and geriatric assessment in CLL management.
Main Results:
- Physiological age and comprehensive geriatric assessment are crucial for tailoring CLL treatment in older patients.
- Older age, indicated by a frailty index, correlates with poorer prognosis in CLL.
Conclusions:
- Novel therapeutic options show promise in reducing mortality and treatment toxicity for elderly CLL patients.
- Personalized treatment strategies considering physiological age are essential for improving outcomes in older adults with CLL.
Background:
Chronic lymphocytic leukemia (CLL) occurs primarily in the elderly, and the majority of deaths attributable to CLL occur in persons 65 years of age or older. The greater number of comorbidities and reduced functionality associated with aging have also made successful treatment of CLL in the elderly more difficult.
Methods:
The authors reviewed current epidemiology and guidelines for treatment of CLL, as well as recently approved therapies and studies of physiological aging.
Results:
Determination of physiological age and performance of a thorough geriatric assessment play critical roles in the selection of optimal therapeutic approaches for older patients diagnosed with CLL.
Conclusion:
Older age, expressed via a frailty index, is a prognostic factor for poorer outcome in patients with CLL. However, several novel treatment options may result in reduced mortality and lessened treatment-related toxicity in older CLL patients.
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