title: Chronic Lymphocytic Leukemia in the Elderly, Which Investigations Are Necessary: A Map for the Practicing Oncologist.
abstract: BACKGROUND
  Chronic lymphocytic leukemia (CLL), the most prevalent leukemia in the Western world, is predominantly a disease of older individuals who also have other comorbidities as well as declining organ and bone marrow reserve. Although chemoimmunotherapy is the frontline therapy for fit CLL patients who can tolerate the therapy, many elderly patients cannot tolerate such intense therapy.
  
  
  METHODS
  The authors first reviewed the most recent findings concerning CLL cytogenetics, molecular biology, and prognostic models. They then surveyed recent and ongoing trials of novel CLL agents and strategies, with a focus on those most relevant to elderly patients.
  
  
  RESULTS
  Novel therapies, revised staging procedures, and careful assessment of individual patients' frailty and functional status will allow clinicians to provide optimal care management for older CLL patients.
  
  
  CONCLUSIONS
  Therapy for the elderly CLL population must be tailored to each patient's fitness level and comorbid conditions, with special consideration for the potential quality-of-life impacts of various treatment recommendations.
authors.affiliation: Department of Malignant Hematology, Moffitt Cancer Center, Tampa, FL 33612, USA. Javier.Pinilla@Moffitt.org.
authors.forename: Javier
authors.initials: J
authors.lastname: Pinilla-Ibarz
authors.forename: Josephine
authors.initials: J
authors.lastname: Emole
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood / Q000235:genetics / Q000378:metabolism; D015897:Comorbidity; D020732:Cytogenetic Analysis; D016330:Frail Elderly; D050438:Genes, Immunoglobulin Heavy Chain; D006801:Humans; D007167:Immunotherapy / Q000379:methods; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000235:genetics / Q000473:pathology* / Q000628:therapy*; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor