title: Treatment of elderly patients with chronic lymphocytic leukemia: an unmet cinical need.
abstract: In chronic lymphocytic leukemia (CLL), the most prevalent lymphoid malignancy in western countries, patients have a median age at diagnosis of 72 years. In the last few years, there has been remarkable progress in understanding the biology of CLL, the detection of molecular prognostic factors and the development of more effective therapies. However, many of the milestone studies were conducted in populations that were considerably younger than the average age of the CLL population. Today, the challenge is to improve management of elderly patients. In this population, outcome of treatment with newer highly effective therapies is often compromised by comorbidities and poor performance status. Decision on how elderly patients should be treated is thus a complex issue. The management of these patients should rely on the development of risk-stratified treatment strategies based on the assessment of individual functional status and the biologic characteristics of CLL. New single agents with reduced toxic effects (i.e., inhibitors of BCR signalling) that have achieved promising results in Phase I/II studies when available should modify the paradigm of the treatment of elderly patients with CLL.
authors.affiliation: Dipartimento Onco-Ematologico Azienda Ospedaliera Pugliese-Ciaccio, Catanzaro, Italy. smolica@libero.it
authors.forename: Stefano
authors.initials: S
authors.lastname: Molica
authors.forename: Maura
authors.initials: M
authors.lastname: Brugiatelli
authors.forename: Fortunato
authors.initials: F
authors.lastname: Morabito
authors.forename: Felicetto
authors.initials: F
authors.lastname: Ferrara
authors.forename: Emilio
authors.initials: E
authors.lastname: Iannitto
authors.forename: Nicola
authors.initials: N
authors.lastname: Di Renzo
authors.forename: Silvana
authors.initials: S
authors.lastname: Capalbo
authors.forename: Pellegrino
authors.initials: P
authors.lastname: Musto
authors.forename: Francesco
authors.initials: F
authors.lastname: Di Raimondo
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000175:diagnosis* / Q000188:drug therapy / Q000628:therapy*; D008297:Male; D020380:Needs Assessment