title: Diffuse Large B-cell Lymphoma in the elderly: standard treatment and new perspectives.
abstract: Diffuse large B-cell lymphoma (DLBCL) is the most common histotype in non Hodgkin lymphoma, with a peak incidence in the sixth decade. The standard treatment for elderly FIT DLBCL patients is Rituximab-CHOP; in unfit and frail patients, chemotherapy at reduced intensity should be considered. Areas covered: In this article, we will review use of standard therapies and new drugs investigated such as immonomudulating agents (IMiDs), Bruton Tyrosine Kinase (BTK), in fit, unfit, frail and very elderly DLCBL patients. Expert commentary: R-CHOP21 in fit DLBCL patients is still the standard of care, while in elderly unfit patients a reduction of doses of cytotoxic drugs or schemes that avoid antracycline should be considered. The Comprensive Geriatric Assesment based in age, comorbidities and functional abilities of daily living is an important tool in elderly, in order to discriminate between fit, unfit or frail patients. Novel drugs represent valid therapeutic options in relapsed/refractory setting so continued participation in clinical trials should be encouraged.
authors.affiliation: a Hematology , Città della Salute e della Scienza Hospital and University , Turin , Italy.
authors.forename: Annalisa
authors.initials: A
authors.lastname: Chiappella
authors.affiliation: a Hematology , Città della Salute e della Scienza Hospital and University , Turin , Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Castellino
authors.affiliation: a Hematology , Città della Salute e della Scienza Hospital and University , Turin , Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Nicolosi
authors.affiliation: a Hematology , Città della Salute e della Scienza Hospital and University , Turin , Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Santambrogio
authors.affiliation: a Hematology , Città della Salute e della Scienza Hospital and University , Turin , Italy.
authors.forename: Umberto
authors.initials: U
authors.lastname: Vitolo
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002471:Cell Transformation, Neoplastic / Q000235:genetics / Q000378:metabolism / Q000473:pathology; D019468:Disease Management; D055808:Drug Discovery; D015577:Geriatric Assessment; D006801:Humans; D016403:Lymphoma, Large B-Cell, Diffuse / Q000175:diagnosis / Q000453:epidemiology* / Q000209:etiology / Q000628:therapy*; D010641:Phenotype; D011379:Prognosis; D012008:Recurrence; D012306:Risk; D059039:Standard of Care; D016896:Treatment Outcome
keywords: Diffuse large B cell lymphoma; comprehensive geriatric assessment; fit; frail; rituximab-CHOP; unfit