Chronic Lymphocytic Leukemia (CLL)

The majority of patients diagnosed with chronic lymphocytic leukemia (CLL) are of advanced age. These patients are markedly heterogeneous with regard to their fitness and vulnerability. A standard approach to assess fitness in older CLL patients remains to be defined. The spectrum of therapeutic options is broad and treatment should be risk- and fitness-adapted. Fit patients should be treated with the standard of care in CLL while in less fit patients alternative regimens are to be considered. Emerging new drugs (antibodies, small molecules) likely will improve the treatment of both fit and less fit older patients in the next future. This chapter reviews the current knowledge on epidemiology, biology, diagnosis, and therapy of CLL in the elderly in order to provide recommendations for the management of older CLL patients.