Favorable outcomes in elderly patients undergoing high-dose therapy and autologous stem cell transplantation for non-Hodgkin lymphoma Journal Article

Authors: Dahi, P. B.; Tamari, R.; Devlin, S. M.; Maloy, M.; Bhatt, V.; Scordo, M.; Goldberg, J.; Zelenetz, A. D.; Hamlin, P. A.; Matasar, M. J.; Maragulia, J.; Giralt, S. A.; Perales, M. A.; Moskowitz, C. H.; Sauter, C. S.
Article Title: Favorable outcomes in elderly patients undergoing high-dose therapy and autologous stem cell transplantation for non-Hodgkin lymphoma
Abstract: High-dose therapy and autologous stem cell transplantation (HDT-ASCT) can offer potential long-term remission or cure in patients with non-Hodgkin lymphoma (NHL). Limited experience is available on the safety and efficacy of HDT-ASCT in elderly patients. This is a single-center, retrospective study examining outcomes of HDT-ASCT for 202 NHL patients, ages 60 years and older, between January 2001 and December 2012. Overall survival (OS) and progression-free survival (PFS) were analyzed according to age at HDT-ASCT, hematopoietic cell transplantation comorbidity index (HCT-CI), NHL histology, and remission status at the time of HDT-ASCT. The median age was 65 years (range, 60 to 74) and the majority had either diffuse large Bcell lymphoma (n= 73, 37%) or mantle cell lymphoma (n= 69, 34%). One hundred and fifteen patients (57%) had high HCT-CI scores at the time of HDT-ASCT. With a median follow-up of 3.6 years (range, 4 to 11.9 years) for survivors, PFS and OS at 3 years were 60% (95% confidence interval [CI], 53% to 68%) and 73% (95% CI, 67% to 80%), respectively. Transplantation-related mortality (TRM) was 4% both at 100 days and at 1 year after HDT-ASCT. Age and HCT-CI score were not associated with OS or PFS, and high HCT-CI did not correlate with TRM. Seven patients (4%) developed secondary myelodysplastic syndrome or acute myeloid leukemia at a median of 35 months (range, 6 to 48) after HDT-ASCT. In this single-center cohort of elderly patients with NHL undergoing HDT-ASCT, this intervention was proven tolerable and effective, with results similar to those of historic controls in younger patients. Our data suggest that age alone should not preclude HDT-ASCT in elderly patients.
Keywords: adult; cancer survival; aged; acute granulocytic leukemia; major clinical study; overall survival; mortality; cisplatin; cytarabine; ibritumomab tiuxetan; rituximab; follow up; carboplatin; progression free survival; mantle cell lymphoma; etoposide; cyclophosphamide; dexamethasone; melphalan; autologous stem cell transplantation; hematopoietic stem cell transplantation; retrospective study; carmustine; ifosfamide; thiotepa; cancer survivor; cancer regression; myelodysplastic syndrome; nonhodgkin lymphoma; mitoxantrone; comorbidity; large cell lymphoma; radioimmunotherapy; tositumomab i 131; elderly; non-hodgkin lymphoma; autologous transplantation; human; male; female; article; transplantation related mortality
Journal Title: Biology of Blood and Marrow Transplantation
Volume: 20
Issue: 12
ISSN: 1083-8791
Publisher: Elsevier Inc.  
Date Published: 2014-12-01
Start Page: 2004
End Page: 2009
Language: English
DOI: 10.1016/j.bbmt.2014.08.019
PROVIDER: scopus
PUBMED: 25175794
PMCID: PMC5480286
Notes: Export Date: 2 January 2015 -- Source: Scopus
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MSK Authors
  1. Craig Moskowitz
    374 Moskowitz
  2. Sergio Andres Giralt
    535 Giralt
  3. Craig Steven Sauter
    166 Sauter
  4. Andrew D Zelenetz
    554 Zelenetz
  5. Miguel-Angel Perales
    378 Perales
  6. Paul Hamlin
    173 Hamlin
  7. Matthew J Matasar
    121 Matasar
  8. Molly Anna Maloy
    131 Maloy
  9. Sean McCarthy Devlin
    303 Devlin
  10. Valkal Bhatt
    33 Bhatt
  11. Parastoo Bahrami Dahi
    84 Dahi
  12. Roni Tamari
    78 Tamari