Are there any special considerations for treating CML in the very elderly, greater than 85 years old?

When approaching older patients with CML it is important to consider comorbid conditions, medications, organ function, and potential toxicity of therapy. This approach is not that different than it would be for younger patients. However, older patients are more likely to be on more medications or to have organ dysfunction. I think it is especially important to monitor older patients more often to ensure they are tolerating their medication well and I would also have a lower threshold to consider either dose reducing the TKI or starting at a lower dose. I generally use imatinib as first-line in older patients or those with many comorbid conditions, but this doesn't always need to be the case. I would also keep in mind that goals of therapy i...