title: The beneficial local and abscopal effect of splenic irradiation in frail patients with chronic lymphocytic leukaemia.
abstract: BACKGROUND
  Chronic lymphocytic leukaemia (CLL) is a common haematological malignancy that mainly occurs in the elderly population. Patients frequently have comorbidities compromising the use of old and new systemic therapies.
  
  
  RESULTS
  We report the prevalence of comorbidities in patients with CLL as present in the southern region of the Netherlands Cancer Registry. Comorbid conditions were present in 67% of the male and 63% of the female patients, and became more common with increasing age. Furthermore, we describe the beneficial local and abscopal effects of splenic irradiation in four patients with CLL who were not suitable for systemic chemoimmunotherapy because of severe comorbidities, or who were unwilling to undergo systemic therapy.
  
  
  CONCLUSIONS
  Our results show that, although an old tool, splenic irradiation should not be forgotten as a potentially effective palliative treatment option in frail patients with symptomatic CLL.
authors.affiliation: Department of Haematology, Reinier de Graaf Group, Delft, the Netherlands.
authors.forename: A M
authors.initials: AM
authors.lastname: Aalbers
authors.forename: M J
authors.initials: MJ
authors.lastname: Aarts
authors.forename: A D G
authors.initials: AD
authors.lastname: Krol
authors.forename: C A M
authors.initials: CA
authors.lastname: Marijnen
authors.forename: E F M
authors.initials: EF
authors.lastname: Posthuma
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D016330:Frail Elderly; D006801:Humans; D015994:Incidence; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000453:epidemiology / Q000532:radiotherapy*; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D012189:Retrospective Studies; D013154:Spleen / Q000528:radiation effects*; D015996:Survival Rate / Q000639:trends; D016896:Treatment Outcome