HealthlineWhat to Expect with Leukemia as an Older Adult

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Leukemia management in older adults presents distinct clinical challenges that influence diagnosis, treatment selection, and outcomes. Recent data indicates age-specific survival rates and treatment responses, with chronic leukemias showing better long-term outcomes compared to acute variants in the elderly population. The presence of comorbidities and reduced tolerance to intensive therapies significantly impact treatment decisions.

Key Points:

• AML and CLL are the most prevalent leukemia types in older adults, with average diagnosis ages of 68 and 70 years respectively
• Primary symptoms include weight loss, fatigue, night sweats, shortness of breath, and easy bruising/bleeding
• Treatment options vary based on age, overall health, and leukemia type – ranging from watch-and-wait approaches to intensive chemotherapy and targeted therapies
• 5-year relative survival rates for CLL vary significantly by age: 94% (ages 50-64), 90% (ages 65-74), and 77% (ages 75+)
• Acute leukemias in patients over 70 show median survival of 4 months for ALL and 6-12 months for AML
• Treatment challenges specific to older adults include increased comorbidities, reduced tolerance to high-dose chemotherapy, and higher infection susceptibility

HCN Medical Memo
Treatment selection for elderly leukemia patients requires careful consideration of comorbidities, functional status, and leukemia subtype, with targeted therapies offering new options for those unsuitable for intensive chemotherapy.

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