Triple-hit lymphoma in a 95-year-old patient: a case report and literature review

Abstract Introduction: Diffuse large B cell lymphoma (DLBCL) is a highly heterogeneous tumor mainly occuring in the elderly, with approximately 40% of cases occurring in patients over 70 years old and this proportion will increase in the future. High grade B cell lymphomas (HGBL) with MYC and BCL2 and BCL6 rearrangements, so called triple-hit lymphomas (HGBL-THL), which usually presents a high-aggressive clinical behavior as well as to be associated with a very poor outcome. However, there are no standard treatment strategies for very elderly HGBL-DHL/THL patients, it still remains a challenge for clinicians. Case Presentaion: we report a case of a 95-year-old patient diagnosed with diffuse large B-cell lymphoma (HGBL-THL, non-germinal central type, stage IV group A, IPI 5 points, high risk group), coronary atherosclerotic heart disease (paroxysmal atrial fibrillation, cardiac insufficiency), hypertension, treated with chemotherapy, radiotherapy and targeted drug therapy obtained better outcome of keeping alive for 1 year. Conclusion: For very elderly HGBL-THL patients, a careful assessment of performance, nutritional status and comorbidities are needed before treatment. Novel therapies including immunotherapy, targeted therapy and chimeric antigen receptor T (CAR-T) cell therapy may provide benefit.