Treatment algorithm for newly diagnosed older HL patients. All patients should undergo a GA to determine fitness prior to initiation of treatment, which should include at least evaluation of ADL and comorbidities (see Table 1) and calculation of noncancer expected survival (https://eprognosis.ucsf.edu/leeschonberg.php). Treatment may be divided by disease stage (early stage vs advanced stage). Treatment options are based on published data and investigator experience (listed by order of preference); a clinical trial should always be considered. ¹There should be consideration of a prephase of steroid therapy, prior to initiation of definitive therapy, especially in frail and/or symptomatic patients; this should be given after completion of a PET scan. ²ABVD may be used vis-à-vis the RATHL study design, with treatment decisions based on the PET scan following cycle 2; however, escalation to BEACOPP for positive PET-2 should not be done. ³Therapy for patients who are classified as unfit based primarily on cardiac status, but who are otherwise stable without loss of ADL and minimal other comorbidities, may include Stanford V or BCVPP therapy. A(B)VD, doxorubicin, bleomycin, vinblastine, dacarbazine, with inclusion of bleomycin at physician discretion or a priori exclusion of bleomycin (ie, AVD); BCVPP, carmustine, cyclophosphamide, vinblastine, procarbazine, and prednisone; Bv/CAP, brentuximab, cyclophosphamide, doxorubicin, and prednisone; PVAG, prednisone, vinblastine, doxorubicin, and gemcitabine; RATHL, Response Adapted Therapy in Advanced Hodgkin Lymphoma; VEPE(M)B, vinblastine, cyclophosphamide, procarbazine, etoposide, mitoxantrone, and bleomycin, with inclusion of mitoxantrone at physician’s discretion or a priori exclusion of mitoxantrone. * There are additional published definitions that have defined patient fitness, which include ages ≥80 years (regardless of other factors) and other variations in CIRS-G scoring (eg, <5 comorbidities score of 2, etc).