ABSTRACT
The chronic leukemias are defined as a group of hematologic neoplasms with a clinical course that is measured in years rather than in the weeks that used to characterize the clinical course of the acute leukemias. The distinction was made in the era before any effective therapy was available for the acute leukemias and rapid death was the usual outcome. As a result, the chronic leukemias were considered to be ‘favorable’ diseases because of their longer prognosis. In young patients, advances in the treatment of the acute leukemias have been dramatic, frequently resulting in cure, and as a result the chronic leukemias are no longer considered so ‘favorable’. In older patients, progress in treating the acute leukemias has been much more modest, and as a rule the prognosis of the chronic leukemias remains the better of the two. The broad categories of the chronic leukemias that are encountered in the older person are listed in Table 46.1.
