Non-Hodgkin Lymphoma (NHL) is a malignant disease of the lymphoid and hematopoetic system with an annual incidence of 60,000 cases/year in the United States accounting for over 18,000 deaths annually. NHL is a heterogeneous malignancy with a median age of 65 at the time of diagnosis. Most clinical trials that have established current standards of care did not include elderly patients, especially those who are above the age of 80. Reasons for such under representation are not well-defined but several factors are hypothesized. Patients above the age of 80 have many co-morbid conditions that might exclude them from enrollment on clinical studies that are usually designed for more fit individuals. In addition, investigators are often reluctant to propose trials to elderly patients as their response to therapy might be suboptimal compared with younger patients affecting the overall data.