The Role of Geriatric Assessment in the Management of Diffuse Large B-Cell Lymphoma

Simple Summary The treatment choice for an older patient with diffuse large B-cell lymphoma (DLBCL) is challenging due to the complexity of the patient. Among the several available tools to evaluate an older subject with DLBCL, the simplified geriatric assessment (sGA) categorizes patients as fit, unfit, or frail and has been validated to predict the risk of death. The elderly prognostic index (EPI), which combines sGA and IPI scores and hemoglobin level, is the first prognostic score for older patients, with three risk groups for survival. New validated tools will help physicians choose the best treatment for elderly patients with DLBCL, further contributing to improving the personalized approach to elderly subjects.Abstract The treatment choice for an older patient with diffuse large B-cell lymphoma (DLBCL) depends on many other factors in addition to age, which alone does not reflect the complexity of the aging process. Functional features and comorbidity incidence differ not only between younger and older patients but also among older patients themselves. The comprehensive geriatric assessment (CGA) quickly evaluates fitness status by investigating the patient's different functional areas, degree of autonomy, and presence of comorbidities. Various tools are available to evaluate frailty; which assessment tool to use should be based on the clinical aim. The simplified geriatric assessment (sGA) from the elderly project by the Fondazione Italiana Linfomi, prospectively tested on the largest number of patients, categorizes patients as fit, unfit, or frail, with a decreasing rate of overall survival. The elderly prognostic index (EPI), which combines sGA and IPI scores and hemoglobin level, is the first prognostic score for older patients, with three risk groups for survival. Future GAs should consider new parameters, including sarcopenia, which appears to be inversely related to survival. New tools based on prospective studies can help physicians choose the best treatment in light of the individual patient's characteristics.