a Hematology , Città della Salute e della Scienza Hospital and University , Turin , Italy.
Expert Rev Hematol. 2017 Apr;10(4):289-297. doi: 10.1080/17474086.2017.1305264. Epub 2017 Mar 27.
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.
弥漫性大 B 细胞淋巴瘤（DLBCL）是非霍奇金淋巴瘤中最常见的组织学类型，发病高峰在第六个十年。对于 fit 的老年 DLBCL 患者，标准治疗是利妥昔单抗-CHOP；对于不适合和虚弱的患者，应考虑降低强度的化疗。
在本文中，我们将回顾 fit、不适合、虚弱和非常老年 DLBCL 患者中使用标准疗法和新药物的情况，如免疫调节药物（IMiDs）、布鲁顿酪氨酸激酶（BTK）。
fit 的 DLBCL 患者中仍然使用 R-CHOP21 作为标准治疗，而对于老年不适合的患者，应考虑减少细胞毒性药物剂量或避免蒽环类药物的方案。基于年龄、合并症和日常生活功能能力的全面老年评估是老年患者的重要工具，以区分 fit、不适合或虚弱的患者。新型药物在复发/难治性环境中代表有效的治疗选择，因此应鼓励继续参与临床试验。
