Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Autografting

Transplant-related mortality in patients older than 60 years undergoing autologous hematopoietic stem cell transplantation

Bone Marrow Transplantation volume 27, pages 21–25 (2001)Cite this article

Abstract

Although high-dose therapy with autologous hematopoietic stem cell transplantation (ASCT) is a widely used method of dose intensification in patients with hematological malignancies, patients aged over 60 are generally excluded. We evaluated high-dose therapy and ASCT in 29 cases involving 27 such patients (median age 63 years; range 61–68) with different malignancies. Patients were eligible if they had a good performance status, normal cardiac, respiratory, and hepatic function and a serum creatinine concentration of less than 2 mg/dl (<5 mg/dl in myeloma patients). Engraftment was assessable in 27 procedures. The median time to attain 0.5 and 1 × 109 PMN/l was 13 days (range 9–30) and 14 days (range 10–66), respectively. The median time taken to reach a platelet count greater than 50 × 109/l was 14 days (range 8–223). Five patients (17%) died in the first 100 days after transplant, in two cases due to disease progression. The remaining three patients died as a consequence of transplant-related complications, with an overall transplant-related mortality of 10%. Five patients relapsed and died between 5 and 36 months after transplant. The remaining 17 patients are still alive without disease progression, with an actuarial overall survival of 47% at 42 months (95% CI 33–61). We consider that high-dose therapy with ASCT should be considered in those elderly patients with good performance status and without general organ impairment. Bone Marrow Transplantation (2001) 27, 21–25.

This is a preview of subscription content, access via your institution

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Gratwohl A, Passweg J, Baldomero H, Harmans J . Blood and marrow transplantation activity in Europe 1997. European Group for Blood and Marrow Transplantation (EBMT) Bone Marrow Transplant 1999 24: 231–245

    Article  CAS  Google Scholar 

  2. Alexanian R, Dimopoulos M . The treatment of multiple myeloma New Engl J Med 1994 330: 484–489

    Article  CAS  Google Scholar 

  3. Armitage JO, Weisenburger DD . New approach to classifying non-Hodgkin's lymphomas: clinical features of the major histologic subtypes J Clin Oncol 1998 16: 2780–2795

    Article  CAS  Google Scholar 

  4. Löwenberg B . Acute myeloid leukemia New Engl J Med 1999 341: 1051–1062

    Article  Google Scholar 

  5. Miller CB, Piantadosi S, Vogelsang GB et al. Impact of age on outcome of patients with cancer undergoing autologous bone marrow transplant J Clin Oncol 1996 14: 1327–1332

    Article  CAS  Google Scholar 

  6. Stamatoullas A, Fruchart C, Khalfallah S et al. Peripheral blood stem cell transplantation for relapsed or refractory aggressive lymphoma in patients over 60 years of age Bone Marrow Transplant 1997 19: 31–35

    Article  CAS  Google Scholar 

  7. Moreau P, Milpied N, Voillat L et al. Peripheral blood stem cell transplantation as front-line therapy in patients aged 61 to 65 years: a pilot study Bone Marrow Transplant 1998 23: 1193–1196

    Article  Google Scholar 

  8. Mazza P, Palazzo G, Amurri B et al. Analysis of feasibility of myeloablative therapy and autologous peripheral stem cell (PBSC) transplantation in the elderly: an interim report Bone Marrow Transplant 1999 23: 1273–1278

    Article  CAS  Google Scholar 

  9. Sanz MA, de la Rubia J, Sanz GF et al. Busulfan plus cyclophosphamide followed by autologous blood stem-cell transplantation for patients with acute myeloblastic leukemia in first complete remission: a report from a single institution J Clin Oncol 1993 11: 1661–1667

    Article  CAS  Google Scholar 

  10. De la Rubia J, Sanz GF, Martín G et al. Autologous blood stem cell transplantation (ABSCT) for acute myeloblastic leukemia in first complete remission. Intensification therapy before transplant does not prolong disease-free survival Haematologica 1999 84: 125–132

    CAS  PubMed  Google Scholar 

  11. De la Rubia J, Sanz GF, Martín G et al. Autologous bone marrow transplantation for patients with acute myeloblastic leukemia in relapse after autologous blood stem cell transplantation Bone Marrow Transplant 1996 18: 1167–1173

    CAS  PubMed  Google Scholar 

  12. Bearman SI, Appelbaum FR, Buckner CD et al. Regimen-related toxicity in patients undergoing bone marrow transplantation J Clin Oncol 1988 6: 1562–1568

    Article  CAS  Google Scholar 

  13. Kaplan EL, Meier P . Nonparametric estimation from incomplete observations J Am Stat Assoc 1958 53: 457–481

    Article  Google Scholar 

  14. Dixon WJ . BMDP Statistical Software University of California: Berkeley, CA 1990

    Google Scholar 

  15. Bladé J, Samson D, Reece D et al. Criteria for evaluating disease response and progression in patients with multiple myeloma treated by high-dose therapy and haemopoietic stem cell transplantation Br J Haematol 1998 102: 1115–1123

    Article  Google Scholar 

  16. Montanari M, Olivieri M, Brunori D et al. Very low toxicity in PBPC autotransplantation for elderly patients: a single center experience Bone Marrow Transplant 2000 25: (Suppl. 1) S73

    Article  Google Scholar 

  17. Sweetenham JW, Pearce R, Philip T et al. High-dose therapy and autologous bone marrow transplantation for intermediate- and high-grade non-Hodgkin's lymphoma in patients aged 55 years and over: results from the European Group for Bone Marrow Transplantation. The EBMT Lymphoma Working Party Bone Marrow Transplant 1994 14: 981–987

    CAS  PubMed  Google Scholar 

  18. Dumontet C, Ketterer N, Espinouse D et al. Reduced progression-free survival in elderly patients receiving intensification with autologous peripheral blood stem cell reinfusion for multiple myeloma Bone Marrow Transplant 1998 21: 1037–1041

    Article  CAS  Google Scholar 

  19. Siegel DS, Desikan KR, Mehta J et al. Age is not a prognostic variable with autotransplants for multiple myeloma Blood 1999 93: 51–54

    CAS  PubMed  Google Scholar 

  20. Attal M, Harosseau JL, Stoppa AM et al. A prospective, randomized trial of autologous bone marrow transplantation and chemotherapy in multiple myeloma New Engl J Med 1996 335: 91–97

    Article  CAS  Google Scholar 

  21. Cahn JY, Labopin M, Mandelli F et al. Autologous bone marrow transplantation for first remission acute myeloblastic leukemia in patients older than 50 years: a retrospective analysis of the European Bone Marrow Transplant Group Blood 1995 85: 575–579

    CAS  PubMed  Google Scholar 

  22. Gorin NC, Labopin M, Pichard P et al. Higher dose of peripheral blood stem cells is critical to improve the outcome of patients over 60 years of age autografted for acute myelocytic leukemia Bone Marrow Transplant 2000 25: (Suppl.1) S6

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bone Marrow Transplant Unit, Hematology Service, University Hospital La Fe, Valencia, Spain

    J de la Rubia, S Saavedra, GF Sanz, G Martín, F Moscardó, J Martínez, I Jarque, C Jiménez & MA Sanz

Authors
  1. J de la Rubia
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S Saavedra
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. GF Sanz
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. G Martín
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. F Moscardó
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J Martínez
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. I Jarque
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. C Jiménez
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. MA Sanz
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

de la Rubia, J., Saavedra, S., Sanz, G. et al. Transplant-related mortality in patients older than 60 years undergoing autologous hematopoietic stem cell transplantation. Bone Marrow Transplant 27, 21–25 (2001). https://doi.org/10.1038/sj.bmt.1702736

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.bmt.1702736

Keywords

This article is cited by

Search

Advanced search

Quick links