title: Approach to therapy of diffuse large B-cell lymphoma in the elderly: the International Society of Geriatric Oncology (SIOG) expert position commentary.
abstract: Diffuse large B-cell lymphoma (DLBCL) is a treatable and potentially curable malignancy that is increasing in prevalence in the elderly. Until recently, older patients with this malignancy were under-represented on clinical treatment trials, so optimal therapeutic approaches for these patients were generally extrapolated from the treatment of younger patients with this disorder. Because of heightened toxicity concerns, older patients were sometimes given reduced dose therapy, potentially negatively impacting outcome. Geriatric considerations including functional status and comorbidities often were not accounted for in treatment decisions. Because of these issues as well as the lack of treatment guidelines for the elderly population, the International Society of Geriatric Oncology convened an expert panel to review DLBCL treatment in the elderly and develop consensus guidelines for therapeutic approaches in this patient population. The following treatment guidelines address initial DLBCL therapy, in both limited and advanced stage disease, as well as approaches to the relapsed and refractory patient.
authors: Department of Medicine, University of Minnesota, Veterans Affairs Medical Center, Minneapolis. Electronic address: morri002@umn.edu.
authors: V A
authors: VA
authors: Morrison
authors: Memorial Sloan-Kettering Cancer Center, New York City, USA.
authors: P
authors: P
authors: Hamlin
authors: Hematology/Oncology Service, University of Bordeaux and Institut Bergonié, Bordeaux, France.
authors: P
authors: P
authors: Soubeyran
authors: Department of Internal Medicine V (Haematology and Oncology), Innsbruck Medical University, Innsbruck, Austria.
authors: R
authors: R
authors: Stauder
authors: Department of Medicine, University of Minnesota, Veterans Affairs Medical Center, Minneapolis.
authors: P
authors: P
authors: Wadhwa
authors: Institut Multidisciplinaire d'Oncologie, Clinique de Genolier, Genolier, Switzerland.
authors: M
authors: M
authors: Aapro
authors: Memorial Sloan-Kettering Cancer Center, New York City, USA; Memorial Sloan-Kettering Cancer Center, Commack, USA.
authors: S M
authors: SM
authors: Lichtman
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D015897:Comorbidity; D015577:Geriatric Assessment; D005853:Geriatrics / Q000592:standards*; D006801:Humans; D007167:Immunotherapy / Q000009:adverse effects / Q000379:methods*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000276:immunology / Q000401:mortality / Q000628:therapy*; D008495:Medical Oncology / Q000592:standards*; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D011878:Radiotherapy / Q000009:adverse effects; D012008:Recurrence; D012074:Remission Induction; D012307:Risk Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: B-cell lymphoma; chemoimmunotherapy; elderly; frailty; large cell lymphoma; radiation therapy