Chronic lymphocytic leukemia (CLL) is a disease of the elderly, but chronological age does not accurately discriminate frailty status at the inter-individual level. Frailty describes a person’s overall resilience. Since CLL is a stressful situation, it is relevant to assess the patient´s degree of frailty, especially before starting antineoplastic treatment. We are in the era of targeted therapies, which have helped to control the disease more effectively and avoid the toxicity of chemo (immuno) therapy. However, these drugs are not free of side effects and other aspects arise that should not be neglected, such as interactions, previous comorbidities, or adherence to treatment, since most of these medications are taken continuously. The challenge we face is to balance the risk of toxicity and efficacy in a personalized way and without forgetting that the most frequent cause of death in CLL is related to the disease. For this purpose, comprehensive geriatric assessment (GA) provides us with the opportunity to evaluate multiple domains that may affect tolerance to treatment and that could be improved with appropriate interventions. In this review, we will analyze the state of the art of GA in CLL through the five Ws.
慢性淋巴细胞白血病（CLL）是一种老年性疾病，但实际年龄并不能准确区分个体间的衰弱状态。衰弱描述了个体的整体恢复能力。由于CLL是一种应激状态，评估患者的衰弱程度尤为重要，尤其是在开始抗肿瘤治疗之前。我们正处于靶向治疗时代，这些疗法有助于更有效地控制疾病，并避免化疗（免疫）治疗的毒性。然而，这些药物并非没有副作用，其他方面也不容忽视，例如药物相互作用、既往合并症或治疗依从性，因为大多数药物需要持续服用。我们面临的挑战是以个性化的方式平衡毒性和疗效风险，同时不应忘记CLL最常见的死亡原因与疾病本身相关。为此，综合老年评估（GA）为我们提供了评估多个领域的机会，这些领域可能影响治疗耐受性，并可通过适当干预措施加以改善。在本综述中，我们将通过五个W问题分析CLL中GA的最新进展。
肿瘤(癌症)患者之家