Treatment of a frail and elderly patient with diffuse large B-cell lymphoma on maintenance dialysis: Attenuated immunochemotherapy and adapted care

Purpose of the study: Diffuse large B-cell lymphoma (DLBCL) is the most common lymphoid malignancy worldwide.1 Its incidence increases with age and about 40% of cases occur in patients over 70 years.1 Many older patients with DLBCL, notably the frail elderly, cannot tolerate standard chemotherapy. In addition, tolerance to treatment is also affected by physiological changes related with ageing, such as declining renal function, and the frequency of renal insufficiency in cancer patients is high.2 There is little data regarding the management of frail elderly patients with DLBCL, and even less is known about treatment of such patients on hemodialysis (HD). Nevertheless, recent trials show that a therapy with curative intent is still possible for elderly with DLBCL and adapted chemotherapy can offer long life expectancy.3,4,5 We describe the treatment with R-miniCHOP in a frail elderly patient undergoing HD.