Treatment of cutaneous B-cell lymphoma, leg type, with age-adapted combinations of chemotherapies and rituximab.

I n contrast with most primary cutaneous B-cell lymphomas, primary cutaneous large B-cell lymphomas, leg type (PCLBCLs-LT) are often lifethreatening. Owing to their occurrence in elderly patients (many patients aged 80 years), these lymphomas have often been treated with radiotherapy alone or palliative chemotherapies, resulting in 5-year survival rates around 50%. Recently, the addition of rituximab to the standard CHOP regimen (cyclophosphamide, doxorubicin, vincristine, and prednisone) (R-CHOP) was found to prolong survival in 60to 80-year-old patients with nodal diffuse large B-cell lymphomas (DLBCLs). Although this result was not directly applicable to older patients with PCLBCL-LT, it rapidly led to a significant shift in French practice, consisting in using the classic R-CHOP regimen in patients younger than 80 years and in generally good condition, and less intensive combinations of rituximab and polychemotherapies (R-PCTs) in the oldest and/or frailest patients. To our knowledge, such an approach has never been evaluated.