Management of unfit patients with unfavourable non-Hodgkin's lymphomas

Lymphoma is a malignant disease that often occurs in elderly patients. Although many treatment options are available, comorbidities and limitations of functional reserves limit their use in frail patients. Still, because of the high sensitivity of disease to these treatments, even reduced doses and schedules may allow long-term disease control or even cure. The question that remains is how to use these treatments while controlling risks. Fortunately, both biological and clinical researches allow for progress that will help clinicians improve treatment strategies. During the last years, interest for research in the elderly with lymphoma has increased. Most of it concerned fit patients but not only. Among those, availability of specific monoclonal antibodies, which improve treatment efficiency without significantly increasing toxicity, appears as a major step forward which should be further developed. Yet, recent data has also been published on other topics including trials on frail patients and specific biological data. Early evaluation of response is also among important topics which should be scrutinized. Overall, recently published results raise hopes for future management of our patients and more is expected soon.