Management of chronic lymphocytic leukemia (CLL) in the elderly: A position paper from an international Society of Geriatric Oncology (SIOG) Task Force

Reinhard Stauder, B. Eichhorst, M. E. Hamaker, K. Kaplanov, V. A. Morrison, A. Österborg, I. Poddubnaya, J. A. Woyach, T. Shanafelt, L. Smolej, L. Ysebaert, V. Goede

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

Chronic lymphocytic leukemia (CLL) mainly affects older people: the median age at diagnosis is > 70 years. Elderly patients with CLL are heterogeneous with regard both to the biology of their disease and aging. Following the diagnosis of CLL in an elderly individual, careful risk assessment is essential when treatment options are evaluated. This includes not only clinical staging and evaluation of disease-specific prognostic biomarkers such as 17p deletion and TP53 mutation, but also of comorbidities, physical capacity, nutritional status, cognitive capacity, ability to perform activities of daily living and social support. Comorbidity scoring and geriatric assessment tools are helpful in achieving such multidimensional evaluation in a systematic manner. The introduction of new drugs including novel monoclonal antibodies and kinase inhibitors offers enhanced opportunities for the treatment of elderly patients with CLL. This position paper of a Task Force of the International Society of Geriatric Oncology (SIOG) reviews currently available evidence relevant to such patients. All types of elderly patient (i.e. chronological age > 65-70 years) are considered, from robust (fit) to vulnerable (unfit) to the terminally ill. Among the topics covered are the following: (i) the relationship between chronological age, prognosis and survival, (ii) assessment of biological aging, (iii) biological age as a determinant of treatment feasibility and tolerance and (iv) tailoring of both first and further-line treatment to the circumstances of the individual patient.

Original languageEnglish (US)
Pages (from-to)218-227
Number of pages10
JournalAnnals of Oncology
Volume28
Issue number2
DOIs
StatePublished - 2017

Fingerprint

Advisory Committees
B-Cell Chronic Lymphocytic Leukemia
Geriatrics
Comorbidity
Geriatric Assessment
Terminally Ill
Aptitude
Sequence Deletion
Therapeutics
Activities of Daily Living
Nutritional Status
Social Support
Phosphotransferases
Biomarkers
Monoclonal Antibodies
Survival
Pharmaceutical Preparations

Keywords

  • Assessment
  • Chronic lymphocytic leukemia
  • Comorbidity
  • Elderly
  • Frailty
  • Targeted agents

ASJC Scopus subject areas

  • Hematology
  • Oncology

Cite this

Management of chronic lymphocytic leukemia (CLL) in the elderly : A position paper from an international Society of Geriatric Oncology (SIOG) Task Force. / Stauder, Reinhard; Eichhorst, B.; Hamaker, M. E.; Kaplanov, K.; Morrison, V. A.; Österborg, A.; Poddubnaya, I.; Woyach, J. A.; Shanafelt, T.; Smolej, L.; Ysebaert, L.; Goede, V.

In: Annals of Oncology, Vol. 28, No. 2, 2017, p. 218-227.

Research output: Contribution to journalArticle

Stauder, R, Eichhorst, B, Hamaker, ME, Kaplanov, K, Morrison, VA, Österborg, A, Poddubnaya, I, Woyach, JA, Shanafelt, T, Smolej, L, Ysebaert, L & Goede, V 2017, 'Management of chronic lymphocytic leukemia (CLL) in the elderly: A position paper from an international Society of Geriatric Oncology (SIOG) Task Force', Annals of Oncology, vol. 28, no. 2, pp. 218-227. https://doi.org/10.1093/annonc/mdw547
Stauder, Reinhard ; Eichhorst, B. ; Hamaker, M. E. ; Kaplanov, K. ; Morrison, V. A. ; Österborg, A. ; Poddubnaya, I. ; Woyach, J. A. ; Shanafelt, T. ; Smolej, L. ; Ysebaert, L. ; Goede, V. / Management of chronic lymphocytic leukemia (CLL) in the elderly : A position paper from an international Society of Geriatric Oncology (SIOG) Task Force. In: Annals of Oncology. 2017 ; Vol. 28, No. 2. pp. 218-227.
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