Therapeutic management of hematological malignancies in elderly patients. Biological and clinical considerations. Part III: The chronic leukemias and myelofibrosis
Abstract
The different therapeutic options available for the treatment of chronic leukemias and myelofibrosis are discussed. In reference to chronic myeloid leukemia (CML), the choice of the most appropriate treatment must take into account not only the clinical condition but also the age of the patient. While subjects under 50 might benefit from the options offered by alpha-interferon, bone marrow and peripheral stem cell transplant, in older age groups treatment of the chronic phase must still rely on standard treatment. Chronic lymphocytic leukemia (CLL) and its variants is a disease of mostly middle and late life, with a variable clinical course. Patients show wide differences in morbidity and mortality. Many features have been shown to influence the prognosis, and the most important ones are incorporated into the staging systems currently in use. The results obtained from the study of large trials support the concept that treatment of patients with stable stage A CLL should be postponed until progression of disease. Treatment relies principally on alkylating agents, corticosteroids and radiation therapy; the new nucleoside analogues, such as fludarabine and 2-chlorodeoxyadenosine, have recently acquired established value in improvi...Continue Reading
References
Serum immunoglobulins in B-chronic lymphocytic leukemia. Natural history and prognostic significance
Intensive combination chemotherapy and interferons in the management of chronic myelogenous leukemia
Red cell aplasia in myelofibrosis with myeloid metaplasia. A distinct functional and clinical entity
Phase II clinical trial of fludarabine in chronic lymphocytic leukemia on a weekly low-dose schedule
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