[Supportive care in oncology: a real change for patients?].

With the increased incidence of cancers due to an aging population, and a prolonged survival thanks to advances in cancer treatments, new therapeutic challenges have arisen. The management of symptoms, the tolerance of increasingly effective oncologic treatments and, finally, quality of life are central concerns of patients and their loved ones. Supportive care in oncology has helped meet these challenges, offering a holistic approach, encompassing somatic, psychiatric and social aid.

[Chronic lymphocytic leukemia: when to start a specific treatment?].

This paper reviews the literature to propose guidelines for managing patients with early-intermediate stage chronic lymphocytic leukemia (CLL). Clinical and biological parameters are sufficient to identify a cohort of patients with high-risk CLL at diagnosis who will have disease progression: anemia (Hb < 100 g/l) or thrombocytopenia (platelets < 100 G/l), bone marrow infiltration (> 30% lymphocytes), a rapid doubling time (less than 6 months) or lymphocytes above 300 g/L, splenomegaly and massive lymphadenopathy, systemic symptoms, uncontrolled autoimmune complications. Patients without those characteristics have low-risk CLL.