Elderly or frail patients with diffuse large B-cell lymphoma present a distinct clinical challenge when comorbidities or aging-related vulnerabilities make standard immunochemotherapy unsuitable.

Clinical scenario

This protocol addresses elderly or frail patients where the presence of comorbidities or aging-related vulnerabilities precludes the use of standard immunochemotherapy. While many older patients tolerate standard regimens reasonably well, a subset requires an adapted approach.

Treatment approach

A reduced-intensity immunochemotherapy regimen is typically considered in this setting — the full structured protocol details the specific regimen and evidence-based guidance.

References

While most older patients tolerate R-CHOP reasonably well, some DLBCL patients cannot receive standard immunochemotherapy due to comorbidities or vulnerabilities linked to aging.
Using a reduced intensity R-CHOP regimen, commonly referred to as R-miniCHOP, is common in this patient population.
The 2-year PFS with R-miniCHOP is ~50% and this regimen offers a good compromise between efficacy and safety in very elderly or frail patients.

DOI: 10.1038/s41408-026-01458-2

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Treatment of Diffuse Large B-Cell Lymphoma in Elderly or Frail Patients with Comorbidities

References