As mentioned, CLL is the most common leukemia type among the elderly, with a median age at presentation of 65 yr. The disease is extremely rare before the third decade of life and increases after the fourth decade exponentially until the seventh decade (11). The increased practice of periodic blood examinations has also increased the observation of CLL cases at an earlier stage of the disease and, possibly, at a younger age (12,13). Within our series of 1011 CLL patients managed during the 1984-1994 period at our institution, we have observed a progressively increasing number of newly diagnosed CLL cases matched by a constant rate of about 20% per year of young patients (55 yr old or younger) (Figs. 1 and 2). Eleven percent of these patients were 50 yr old, and 9% were between 50 and 55 yr old; 9% were between 40 and 50 yr, and only 1.5% were younger than 40 yr. In their series, Bennett et al. (2) and Molica et al. (7) reported that 7-12% of CLL patients were younger than 50 yr.
As previously described (3-7,9), in our series younger and older patients showed at diagnosis a similar distribution of different clinical features: stage, lymphocyte count, bone marrow histology, lymphocyte doubling time (LDT), and active disease (AD). The only unexplained difference between the two age groups in our series and also in the series described by Montserrat et al. (3) was a significantly higher male/female ratio in the younger group that could be partly caused by a hypothetical protective endocrine effect in young female subjects (Fig. 2).
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