Gentle yet effective therapies are called for when treating patients with chronic lymphocytic leukemia (CLL) who are age 65 years and older. While there is no standard treatment for most of those patients, several regimens are being tested in clinical trials, according to Alessandra Ferrajoli, MD, who spoke at the 17th Annual International Congress on Hematologic Malignancies.
The treatment of elderly patients with CLL is an important area of study because 69% of patients with the disease fit into that category at the time of diagnosis, making them more likely to have comorbidities that compromise their ability to tolerate aggressive treatments, said Ferrajoli, an associate professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center. In fact, she said, at age 70 years, one-third of such patients have two or more comorbidities. Compared with people age 65 years and older in the general population, people in that age group who have CLL face a significantly increased mortality rate, she added.
I'd suggest that age is just the first indicator for how any individual will tolerate any form of treatment in that it provides a broad picture of the state of your body, given the gradual decline in the performance of our heart, lungs, liver, kidneys, etc. with age. I'm sure we all know people in their eighties that are fitter than some others in their fifties! As Cllcanada states, comorbidities compromise an individual's ability to tolerate aggressive treatments, which should be a powerful incentive for us to all work to maintain and if possible improve our health. While we can't do much about our age, we do have the power to influence how well we are travelling!
I agree with AussieNeil that many older people can be as if not fitter than those much younger - I am on watch and wait but this drives me on to maintain as high a fitness level as possible.
I did have to look up what comorbidities meant - a new word to me !!
This really struck a chord with me. After four years of watch and wait, with increasing discussion over the last 18 months of whether the time had arrived for me to start treatment, the need to confirm a holiday booking to S E Asia made several months previously somehow jolted me into the need for treatment. It was clear that it was not sensible to travel so far and for the first time my travel insurance would not cover CLL. I accepted the need for treatment just before Christmas. By that time I had somehow slipped over an age line, and reached 65 + 1 month. I don't feel any different to how I felt when I was 64 + 11 months!
As a result, having previously been told that I should have FCR, I agreed to take part in a clinical trial (the ORIGIN trial), for previously untreated elderly patients with CLL, comparing lenalidomide with chlorambucil. I'm currently on lenalidomide. Time will tell whether I make it onto FCR!
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