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CLL in patients under 40

CLL in patients under 40

Question

Dear OncoLink "Ask The Experts,"

I am 38 years old and in the past two weeks my local hematologist has diagnosed me with CLL. My white count is around 15,000 a bone marrow biopsy showed "subtle" infiltration and a CT scan showed no other involvement. I am awaiting appointments with a leukemia specialist at and a BMT specialist. My primary care doctor is very concerned that all the information that is available on treatments and prognosis seems to be based on the cases of people over 50 years old.

I have a few questions:

  1. Is there a prevalent theory about treating stage 0 CLL patients my age?
  2. Where can I find more information about such things for people with CLL who are under 40?
 


Answer

Selina M. Luger, MD, Director of the Leukemia Program and Assistant Professor of Medicine at the University of Pennsylvania, responds:

Although we usually think of CLL as a disease of patients over the age of 50, we do see patients with this disease who are younger. In general we tend to reserve aggressive therapy for more advanced disease. There is really no indication for initiating therapy at this point as (1) time will only tell us what the natural history of your disease is and (2) our treatments evolve with time as we learn more and we may have different approaches to therapy when you do need treatment.

The leukemia and lymphoma society should be able to provide with some information and contacts that may be helpful.