title: Treatment and management of chronic lymphocytic leukemia in the elderly: what the pharmacist clinician should know.
abstract: OBJECTIVE
  To review the literature for current treatment options and supportive care management for elderly patients with chronic lymphocytic leukemia (CLL).
  
  
  METHODS
  PubMed searches using the terms chronic lymphocytic leukemia, elderly, practice guidelines, and controlled clinical trials were performed from 1949 through August 2011. Reference lists from relevant articles were examined for additional studies, review articles, and guidelines.
  
  
  METHODS
  Eighty-three articles were generated and abstracted articles were chosen based on trial results that changed clinical practice, resulted in approval of new drugs for CLL by the Food and Drug Administration and/or had clinical relevance to the elderly population.
  
  
  RESULTS
  Fit elderly CLL patients have more treatment options than frail elderly. Most studies include patients younger than 65 years of age, and recent advances in treatment may not prove beneficial for all ages. Clinicians should use available evidence and clinical judgment when treating and monitoring elderly CLL patients.
  
  
  CONCLUSIONS
  Treatment armamentarium has improved over the last decade, yet clinical trials research should include more elderly cohorts as new agents are developed. Increased awareness of supportive care issues improves quality of life for a population with multiple disease complications.
authors.affiliation: Pharmaceutical Management Branch, Cancer Therapy Evaluation Program, Division of Cancer Treatment and Diagnosis, National Cancer Institute, National Institutes of Health, Rockville, Maryland 20852, USA. tmjohnson@mail.nih.gov
authors.forename: Tali M
authors.initials: TM
authors.lastname: Johnson
mesh_terms: D000367:Age Factors; D000368:Aged; D000970:Antineoplastic Agents / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D018849:Controlled Clinical Trials as Topic / Q000379:methods; D017277:Drug Approval; D016330:Frail Elderly; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis / Q000188:drug therapy* / Q000473:pathology; D010595:Pharmacists / Q000458:organization & administration; D017410:Practice Guidelines as Topic; D011788:Quality of Life; D014481:United States; D014486:United States Food and Drug Administration
chemical_list: D000970:Antineoplastic Agents