Chronic lymphocytic leukemia in the young patient

Chronic lymphocytic leukemia is customarily considered a disease of the elderly. However, 10% of patients reported in a variety of clinical trials are less than 50 years of age. Because of the new approaches to treatment with purine analogs, bone marrow transplantations, and monoclonal antibodies, the time is appropriate for reconsideration to the approach to treatment of younger patients. It is now established that the characteristics which predict for prognosis in young patients are similar to those of patients who are older. However, the survival of patients younger than 55 years of age is significantly greater than those older than 55 years of age. The sex distribution appears to be similar in younger patients as with older patients. The response to treatment with purine analogs has enabled the development of procedures for autologous stem cell transplantation. Allogeneic transplantation is being used increasingly with full dose ablative approaches or modified, less intensive regimens. The new approaches to therapy hold promise for improved survival in this subset of patients. Increasingly these patients are being diagnosed at an earlier stage in association with routine physical examinations or laboratory tests for other procedures.