Individualizing treatment

• Selection of a specific treatment approach for an individual patient is based on patient characteristics (age, comorbidities, organ function, performance status, and medical fitness) and the goals of treatment^9,36
• The use of risk-adaptive approaches to therapy calls for weighing the potential benefit that a patient may receive from treatment against the potential adverse events the patient may experience. Generally, it is very important to consider the patient's prognosis, medical fitness, and age when considering the aggressiveness of an approach to treatment⁹
• Risk-adaptive management strategies that incorporate prognostic factors, along with medical fitness status and other patient characteristics have been proposed^36,37 (Table 5)
  • For instance, the German CLL Study Group has used the Cumulative Illness Rating Scale (CIRS), a tool for assessing comorbidities within their clinical trials to distinguish between physically fit and unfit patients³⁶

Table 5. Classification of CLL patients by medical fitness as described by the German CLL Study Group.^36,37

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