Diffuse large B-cell lymphoma in the elderly: impact of prognosis, comorbidities, geriatric assessment, and supportive care on clinical practice. An International Society of Geriatric Oncology (SIOG) expert position paper

Abstract

Diffuse large B-cell lymphoma (DLBCL) is the most common subtype of non-Hodgkin lymphoma in the elderly, and is increasing in incidence. Although significant therapeutic advances have recently been made in the care of older patients with DLBCL, based upon results of randomized clinical trials, many older patients are not eligible for such trials due to comorbidities and functional decline. Pre-treatment evaluation of older patients to ascertain potential tolerance to therapy is especially important in therapeutic decisions for this population. Evaluation by performance status alone is insufficient, especially in the elderly, and consideration of the impact of comorbidities and functional/social decline needs to be included in such assessment. As part of an International Society of Geriatric Oncology (SIOG) task force, the issues of prognosis, comorbidities, geriatric assessment, and supportive care measures in older patients with DLBCL will be reviewed, and recommendations for assessment and allied care made.

Keywords: Comorbidities; Elderly; Frailty; Geriatric assessment; Large cell lymphoma.