Treatment of the elderly patient with diffuse large B cell lymphoma

Paul A. Fields*, David C. Linch

*Corresponding author for this work

    Research output: Contribution to journalLiterature reviewpeer-review

    47 Citations (Scopus)

    Abstract

    The majority of patients with diffuse large B-cell lymphoma are over the age of 60 years and the management of these patients is often sub-optimal. Intensive therapy with curative intent should be given to all patients who can tolerate such therapy, and this requires very careful evaluation of each patient prior to treatment allocation. A detailed history and examination are required, with attention to concomitant disease and existing drug therapy. A quantitative assessment of comorbidity and a comprehensive geriatric assessment (CGA) are valuable adjuncts to physician judgment. For most elderly patients, the R-CHOP regimen (rituximab, cyclophosphamide doxorubicin, vincristine, prednisolone) remains the standard of care. Granulocyte colony-stimulating factor should be given routinely. Reassessment before each cycle of therapy is essential and interim echocardiography should be performed. In patients with cardiac insufficiency there are a number of alternative regimens but no definitive best regimen. In those patients not treated with curative intent a multi-disciplinary approach is essential.

    Original languageEnglish
    Pages (from-to)159-170
    Number of pages12
    JournalBritish Journal of Haematology
    Volume157
    Issue number2
    DOIs
    Publication statusPublished - Apr 2012

    Keywords

    • diffuse large B cell lymphoma
    • elderly
    • management
    • NON-HODGKINS-LYMPHOMA
    • COLONY-STIMULATING FACTOR
    • NONPEGYLATED LIPOSOMAL DOXORUBICIN
    • INTERNATIONAL PROGNOSTIC INDEX
    • CONGESTIVE-HEART-FAILURE
    • STANDARD REGIMEN CHOP
    • DETUDE-DES-LYMPHOMES
    • PHASE-III TRIAL
    • RISK-FACTORS
    • R-CHOP

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