 A stronger chemotherapy with greater side effects (mostly hematologic) is HyperCVAD, often given in the hospital setting, with rituximab and generally to fitter patients (some of which are over 65).HyperCVAD is becoming popular and showing promising results, especially with rituximab.It can be used on some elderly (over 65) patients, but seems only beneficial when the baseline Beta-2-MG blood test was normal.