Description

Chronic lymphocytic leukaemia is the commonest form of leukaemia in caucasians and accounts for 40% of all leukaemias in individuals over the age of 65years. Diagnosis is based on the presence of a lymphocytosis and characteristic immunophenotype. More than 70% of CLL patients are diagnosed at a pre-clinical stage. It is a very heterogeneous disorder with survival ranging from less than 1 year to more than 25 years. For this reason the identification of prognostic markers to guide the clinician in patient management is essential. A substantial  proportion of patients will never progress and will never need treatment for their CLL. Clear guidelines as to who will benefit from chemotherapy are important if patients are to be managed successfully and appropriately. Although incurable with standard therapy, several treatment regimens are very successful in controlling CLL. The challenge for the clinician is to decide on both the timing and intensity of treatment. As patients with CLL are often elderly with significant co-morbidity and in need of prolonged follow up, collaboration between haematologists, elderly care physicians and primary care is essential.