Universität zu Köln

Eichhorst, Barbara, Hallek, Michael and Goede, Valentin (2018). Management of unfit elderly patients with chronic lymphocytic leukemia. Eur. J. Intern. Med., 58. S. 7 - 14. AMSTERDAM: ELSEVIER SCIENCE BV. ISSN 1879-0828

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Abstract

Chronic lymphocytic leukemia (CLL) is a disease characterized by an increasing incidence with age reaching 35/100,000 in patients over 85 years. Elderly CLL patients carry several challenges, which have to be considered particularly in advanced stages including a higher risk of infections and individual differences in comorbidities and geriatric syndromes. Although no specific tool for geriatric evaluation in CLL has been developed so far, several of them (e.g. CIRS or Charlson-Score) have been tested in CLL patients. Several treatment options exist for frontline and relapse therapy in unfit CLL patients. Less intensive chemoimmunotherapy with engineered CD20 antibodies (e.g. obinutuzumab) is one of the treatment options, if TP53 mutation or deletion has been ruled out by genetic testing. Single agent treatment with the Btk-inhibitor ibrutinib is not only approved in relapsed CLL; but also for frontline therapy. The kinase inhibitor idelalisib (plus rituximab) and the bcl2 inhibitor venetoclax are other novel compounds, which showed great efficacy in relapsed CLL even in unfit patients. Treatment decisions in unfit patients have to take patient-related as well as disease-related risk factors into consideration.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eichhorst, Barbara UNSPECIFIED UNSPECIFIED UNSPECIFIED Hallek, Michael UNSPECIFIED UNSPECIFIED UNSPECIFIED Goede, Valentin UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-163672
DOI:	10.1016/j.ejim.2018.02.001
Journal or Publication Title:	Eur. J. Intern. Med.
Volume:	58
Page Range:	S. 7 - 14
Date:	2018
Publisher:	ELSEVIER SCIENCE BV
Place of Publication:	AMSTERDAM
ISSN:	1879-0828
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language PREVIOUSLY UNTREATED PATIENTS; INITIAL THERAPY; OLDER PATIENTS; OPEN-LABEL; RITUXIMAB REGIMEN; 1ST-LINE THERAPY; SUPPORTIVE CARE; CYCLOPHOSPHAMIDE; MULTICENTER; FLUDARABINE Multiple languages Medicine, General & Internal Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16367