Chronic myeloid and lymphocytic leukemias in the elderly: public health challenges in early detection and long-term care

Chronic myeloid leukemia (CML) and chronic lymphocytic leukemia (CLL) predominantly affect older adults, presenting unique challenges in early detection and long-term management. The growing elderly population globally has intensified the public health burden of these chronic leukemias, particularly in low-resource settings. This narrative review synthesizes current evidence on the epidemiology, clinical features, early detection, and long-term care of CML and CLL in elderly populations, with a focus on public health implications and region-specific considerations. A structured literature search was conducted across PubMed, Scopus, Web of Science, and Google Scholar, including studies published from 2000 to 2025. Risk-based screening protocols, economic burden, and disparities in low-resource settings were emphasized. CML and CLL incidence increases with age, with median diagnosis ages of 67 and 70 years, respectively. Early detection is often delayed due to non-specific symptoms, limited molecular diagnostics, and sociocultural factors. Long-term management is complicated by comorbidities, treatment adherence challenges, and fragmented care systems. Evidence-based strategies, including risk-based screening, multidisciplinary care, and community-based interventions, improve outcomes. In low-resource settings such as Zimbabwe, disparities in diagnostic capacity, drug availability, and supportive care significantly affect disease outcomes. Economic analyses highlight that early detection and guideline-adherent monitoring are cost-effective, reducing complications and optimizing resource utilization. Effective management of CML and CLL in elderly populations requires integrated strategies combining early detection, personalized care, and health system strengthening. Tailored interventions addressing both clinical and socioeconomic determinants of health, particularly in low-resource environments, are essential to improve survival, quality of life, and cost efficiency.