Treatment of the elderly patient with diffuse large B cell lymphoma

TY - JOUR

T1 - Treatment of the elderly patient with diffuse large B cell lymphoma

AU - Fields, Paul A.

AU - Linch, David C.

PY - 2012/4

Y1 - 2012/4

N2 - 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.

AB - 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.

KW - diffuse large B cell lymphoma

KW - elderly

KW - management

KW - NON-HODGKINS-LYMPHOMA

KW - COLONY-STIMULATING FACTOR

KW - NONPEGYLATED LIPOSOMAL DOXORUBICIN

KW - INTERNATIONAL PROGNOSTIC INDEX

KW - CONGESTIVE-HEART-FAILURE

KW - STANDARD REGIMEN CHOP

KW - DETUDE-DES-LYMPHOMES

KW - PHASE-III TRIAL

KW - RISK-FACTORS

KW - R-CHOP

U2 - 10.1111/j.1365-2141.2011.09011.x

DO - 10.1111/j.1365-2141.2011.09011.x

M3 - Literature review

SN - 0007-1048

VL - 157

SP - 159

EP - 170

JO - British Journal of Haematology

JF - British Journal of Haematology

IS - 2

ER -