Treatment of non-Hodgkin's lymphomas in the elderly

The number of elderly patients with non-Hodgkin's lymphomas (NHL) is contin uously increasing. The diagnostic and staging procedures should be carried out in elderly patients as careful as in younger patients. Furthermore, for treatment decisions geriatric assessment and the patient's preferences con cerning therapy are essential and have to be considered. The treatment of i ndolent NHL depends on the stage of the disease and the clinical status of the patient. Most of the patients with limited indolent NHL can be treated with curative intent using localized irradiation. Treatment of patients wit h advanced indolent NHL is palliative. In contrast, all stages of aggressiv e NHL can also be treated with curative intent in elderly patients. In limi ted aggressive NHL standard treatment consists of polychemotherapy followed by involved field irradiation. Standard treatment of advanced aggressive N HL is polychemotherapy with cyclophosphamide, adriamycin, vincristine and p rednisone (CHOP). The goal for the near future is to improve perspectives f or elderly patients with NHL. One way is to treat as many of these patients as possible according to current standards. In the field of geriatric onco logy, one of the questions we are often confronted with is the limitation o f treatment, especially in frail patients. This issue is closely associated with ethical considerations which are discussed in another paper.