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Conclusions and Further Reading - Chapter 09

Chapter 09 - Diffuse Large B-Cell Lymphoma in the Elderly: R-CHOP or Adapted Strategy?

Conclusion

All the prospective studies performed in NHL show that age itself should not be a reason to move away from conventional therapy. The standard immunochemotherapy used for this malignancy, R-CHOP, should also be the recommended strategy for elderly patients with DLBCL. The main question is: which elderly patients can or cannot receive this regimen? As life expectancy for these patients is superior to 5 years, the aim of the physician must be to restore the same quality of life to the patient that they were experiencing prior to the DLBCL. A palliative intent in first line must be reserved for those patients with major organ failure preventing any administration of chemotherapy or immunotherapy.

Among the comorbidities or alterations in physiological functions, the nutritional status, simply evaluated with serum albumin, and a poor or decreased mobility capacity seem to be key factors that influence which patients can receive R-CHOP. In the rituximab era, a reduction in chemotherapy dose, mainly regarding anthracyclines, can still provide very good results.

Further Reading

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