Tucci A, Merli F, Fabbri A, et al. - Researchers assessed characteristics of late octogenarians (LO), aged >84, suffering from DLBCL and also intended to determine the best treatment strategy. They analyzed all consecutive cases aged ≥80, recorded in the FIL Elderly Project, a large prospective analysis on elderly DLBCL where a simplified GA (sGA) was employed and the elderly prognostic index (EPI) was constructed. Treatment depended on clinician decision and intensity was described on the basis of relative dose of anthracycline administered: full dose (FD) 70-100%, reduced dose (RD) <70% and palliative (PT) 0%. The 3-y overall survival (OS) was altogether 51% after a median of 30 months (1-59). It significantly varied in UNFIT vs FRAIL patients (pts) (60 vs 43%) and in those with Intermediate vs High EPI score (71 vs 41%). Three-year OS did not differ, based on treatment, between pts receiving FD (62%) or RD (61%), while PT caused worse survival (27%). Significantly worse 3-y OS was experienced by LO vs early octogenarians (EO) aged 80-84 (37 vs 57%). Findings highlight the risk of undertreating pts depending merely on very advanced age. The best treatment choice, even in late octogenarians detected by sGA as not FRAIL, was: a curative intent approach with decreased anthracycline dose. Consideration should be given to inclusion of RTX in palliative treatment for FRAIL pts.