title: New meets old: a case study and review of novel therapeutics for the treatment of CLL in older patients.
abstract: The treatment of older or medically frail patients with chronic lymphocytic leukemia (CLL) presents unique challenges to clinicians attempting to maximize efficacy while avoiding significant toxicity. This case report presents a 75-year-old man with Rai stage II CLL complicated by massive splenomegaly, high-risk cytogenetics, and intolerance to first-line therapy recommended by the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Hodgkin's Lymphomas. A brief summary of his disease and treatment course accompanies a discussion of the special challenges associated with treating this patient population. In addition, emerging novel and targeted therapies, including next-generation monoclonal antibodies and small molecule inhibitors, are reviewed in the broader context of evolving standards of care and the NCCN Guidelines.
authors.affiliation: From the University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Neel K
authors.initials: NK
authors.lastname: Gupta
authors.affiliation: From the University of California San Francisco, Helen Diller Family Comprehensive Cancer Center, San Francisco, California.
authors.forename: Charalambos
authors.initials: C
authors.lastname: Andreadis
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D058846:Antibodies, Monoclonal, Murine-Derived / Q000008:administration & dosage; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D006801:Humans; D000077269:Lenalidomide; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000000981:diagnostic imaging* / Q000188:drug therapy; D008297:Male; D011877:Radionuclide Imaging; D000069283:Rituximab; D013792:Thalidomide / Q000008:administration & dosage / Q000031:analogs & derivatives; D016896:Treatment Outcome
chemical_list: D058846:Antibodies, Monoclonal, Murine-Derived; D000069283:Rituximab; D013792:Thalidomide; D000077269:Lenalidomide