Treating elderly and frail patients with DLBCL is a unique therapeutic challenge since standard chemotherapy is not applicable. We report the outcome of nine patients deemed unable to tolerate chemotherapy who were treated with rituximab plus prednisone with or without radiotherapy at our institute between 2012 and 2021. Median age was 82 years (range 75 - 93). While four of our patients had no clinical benefit, three patients profited notably from therapy and another two achieved a mixed response. Median OS was 7.0 months and median PFS was 3.2 months. Median PFS in responders and non-responders was 25.1 months and 2 days, respectively. Positive outcomes were associated with ECOG performance status < 4, non-severe comorbidities, mainly localized disease, IPI non high risk and those who received radiation to the main tumor mass. Our data suggests that selected frail patients may benefit from therapy with rituximab plus prednisone.
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