From the Guidelines
Chronic Lymphocytic Leukemia (CLL) typically affects older adults, with the median age at diagnosis being around 72 years, as reported in the most recent study 1.
Key Points
- The median age at diagnosis of CLL is 72 years, with most patients being diagnosed after age 65 1.
- Approximately 70% of patients are diagnosed at older than 65 years of age, and 40% are diagnosed at age ≥75 years 1.
- The risk of developing CLL increases significantly with age, making it predominantly a disease of the elderly 1.
- Age at diagnosis influences treatment decisions, as older patients may have more comorbidities and reduced tolerance for aggressive therapies compared to younger patients with CLL 1.
Age Distribution
The age distribution of CLL is related to the pathophysiology of the disease, which involves the gradual accumulation of abnormal B-lymphocytes over time due to both acquired genetic mutations and age-related decline in immune system function 1.
Comorbidities
Comorbidities are frequently present in older patients with CLL, and the presence of multiple comorbidities was an independent predictor of clinical outcome 1.
Treatment Considerations
Treatment decisions for CLL take into account the patient's age, comorbidities, and functional status, with older patients often requiring less aggressive therapies due to reduced tolerance 1.
From the Research
Typical Age of Onset for Chronic Lymphocytic Leukemia (CLL)
- The median age at diagnosis for patients with CLL is reported to be around 70 years 2.
- Other studies have found the median age at diagnosis to be slightly higher, at 72 years 3, 4.
- The age of onset for CLL is typically above 70 years, with the disease mainly affecting older people 5, 6.
- The median age at diagnosis has been consistently reported to be above 70 years across different studies, with a range of 70-72 years 2, 3, 4, 5, 6.
Factors Influencing Age of Onset
- The disease characteristics, such as chromosomal and molecular abnormalities, can influence the age of onset and treatment options 3.
- Comorbidities, functional status, and fitness also play a crucial role in determining the treatment approach for older patients with CLL 4, 5, 6.
- The introduction of new drugs, including novel monoclonal antibodies and kinase inhibitors, has enhanced opportunities for the treatment of elderly patients with CLL 5, 6.
Treatment Considerations
- Treatment options for CLL include chemoimmunotherapy, monoclonal antibody-based approaches, and small molecules such as ibrutinib, idelalisib, and venetoclax 2, 3, 6.
- The choice of treatment is guided by the patient's performance status, comorbidities, and disease characteristics 3, 4, 5, 6.
- A geriatric evaluation should be considered prior to commencement of cytotoxic therapy in older patients with CLL 6.