diffuse large b cell lymphoma | Large cell diffuse B lymphoma in an elderly: an example of the collaboration between oncologist and Geriatrician

Large cell diffuse B lymphoma in an elderly: an example of the collaboration between oncologist and Geriatrician




Summary
Taking care of frail elderly patients with cancer requires coordination of their management between oncologists, who provide specific treatment, and geriatricians who develop a personalized support care plan. Through a clinical case, we will describe and explain the two phases of geriatric intervention: aid for therapeutic decision-making and the establishment of an intervention to prevent the onset or worsening of geriatric syndromes. In developing the geriatric personalized care plan, the Doctor Geriatrician prioritizes the issues to be taken care of, and the nurse organizes and plans the geriatric intervention ensuring an essential coordinating role between the two Types of support.

Keywords
Geriatric Oncology Geriatric Assessment support B-cell diffuse lymphoma An example of the collaboration between oncologist and Geriatrician about a case of diffuse large B-cell lymphoma in An elderly patient
Abstract
The coordination between oncologist and Geriatrician is necessary for the management of frail elderly cancer patients. Oncologist treats specifically the cancer disease and geriatrician sets up the supportive care adapted to geriatric syndromes detected. With a clinical case as an example, we are going to describe and clarify both phases of the geriatric management: the decision-making support to treat and the organization of an intervention to prevent geriatric syndromes. Geriatrician organizes into hierarchy problems to be taken care and a nurse organizes and plans the intervention. The nurse has an essential role of coordination between management of cancer treatment and geriatric management.

Keywords
Geriatric Oncology Geriatric Evaluation Case Management Diffuse large B-cells lymphoma 

Large cell diffuse B lymphoma in an elderly subject:
An example of the collaboration between oncologist and Geriatrician
An example of the collaboration between oncologist and Geriatrician about a case
of diffuse large B-cell lymphoma in an elderly patient
S. Gérard · C. Gaudin · Mr. Caperan · A. Larrayadieu · C. Goineau · L. Bacony

Summary management of frail elderly patients with
Of cancers requires coordination of their management
Oncologists, who provide the specific treatment, and the
Geriatricians that develop a personalized care plan for
Support. Through a clinical case, we will describe and
Clarify the two phases of geriatric intervention:
Support for therapeutic decision-making and the setting up of a
Intervention to prevent the onset or aggravation of
Geriatric syndromes. In the development of the care plan
Personalized geriatric, the Doctor Geriatrician prioritizes the
Problems to take care of, and the nurse organizes
And plans the geriatric intervention to ensure the role of
Essential coordination between the two types of
Load.
Keywords Oncology geriatrics · Geriatric Assessment ·
Support · Large cell Diffuse B lymphoma
Abstract The coordination between oncologist and Geriatrician
is necessary for the management of frail elderly cancer
Patients. Oncologist treats specifically the cancer disease and
Geriatrician sets up the supportive care adapted to geriatric
Syndromes detected. With a clinical case as an example, we
are going to describe and clarify both phases of the geriatric
Management: The decision-making support to treat and
The organization of an intervention to prevent geriatric syndromes.
Geriatrician organizes into hierarchy problems to be
Taken care and a nurse organizes and plans the intervention.
The nurse has an essential role of coordination between
Management of cancer treatment and geriatric management.
Keywords Geriatric Oncology · Geriatric Evaluation · Box
Management Diffuse large B-cells lymphoma
Mr. M. 85 years old is hospitalized for chest pain
"Erratics" associated with an alteration of the general condition
In the last few weeks with a asthenia, a
Anorexia and slimming weight loss.
The clinical examination is not peculiar. The Cardiac balance Sheet
is reassuring. On the other hand, chest X-ray
Reveals a possible mediastinal opacity.
On the biological level, the patient has anemia
Inflammatory at 10 g/L. The VS is at 100 at the first
Time. LDH is twice normal. The function
Renal disease is altered with a créatinémie initially
206 Μmol/L.
The thoracic scanner (Fig. 1) confirms the presence of a
Voluminous tissue lesion (9 cm) of the anterior mediastinum
With lysis of the sternum explaining the painful symptomatology.
On the other hand, there are multiple adenopathies
SUS-and sous-diaphragmatic.

Diagnosis of diffuse B lymphoma with large cells
is confirmed by biopsy of tissue mass.
This patient will benefit from
Multidisciplinary association with haematological expertise,
A geriatric assessment, with the objective of developing a
Personalized and adapted care plan.
Haematological Expertise
The patient's record is therefore first discussed in
Multidisciplinary Consultation Meeting:
• Who patient 1, with general signs;
• Diffuse B lymphoma with large cell stage IVB by
The tissue extension. Prognostic International Score
Age Adjusted Index (IPI) (AAIPI) to 2;
S. Gérard (*) · Mr. Caperan · A. Larrayadieu · C. Goineau
Mobile Team of Oncogeriatry, CHU of Toulouse, France
E-mail: gerard.s@chu-toulouse.fr
S. Gérard · C. Gaudin · L. Bacony
Coordinating pilot unit in Oncogeriatry,
Midi-Pyrénées, France
Cah. Year Gérontol. (2010) 2:80-84
DOI 10.1007/s12612-010-0057-1
• Proposed treatment with R-mini-CHOP (rituximab,
Cyclophosphamide, doxorubicin, vincristine,
Prednisone) for eight cycles.
A pretherapeutic isotope ventriculography is
Carried out showing a left ventricle hyperkinetic
(without anomaly of segmental kinetics) with a
Ejection fraction at 82% in the context of a deficiency
Cardiac function.
There is therefore no contraindication to the taking into
Theoretical chemotherapeutic load proposed by the team
of hematology.
However, given the particularly advanced age of
Of this patient, a notice to the mobile team of Oncogeriatry
Of the CHU is required.
Geriatric Assessment
Lifestyle
Mr. M., a former Mason, lives at home with his wife of
80 years. They have five children, two of whom are involved in his
Supported. It remains independent for all acts of
Daily life (activities of daily living [ADL] 6/6).
He has no professional help at home.
For a month it is particularly asthénique, and the
Couple came to live with their daughter who represents the caregiver
Main natural.
Competitive comorbidities
• Background: nil.
• Chronic evolutionary pathologies (table 1).
Standardized gerontological evaluation
(table 2).
• Biological data (table 3).
Discussion
In synthesis, patient of 85 years, independent for acts of
Daily life and well-surrounded by his children, presenting
Large cell diffuse B lymphoma.