¹Department of Medicine, Kuopio University Hospital, Kuopio, Finland

Correspondence: Dr E Jantunen, Department of Medicine, Kuopio University Hospital, POB 1777, Kuopio 70211, Finland. E-mail: esa.jantunen@kuh.fi

Received 15 February 2006; Revised 23 August 2006; Accepted 6 September 2006; Published online 16 October 2006.

Abstract

Along with improved supportive care and thus reduced treatment-related mortality, an increasing number of elderly patients (>60 years) with haematological malignancies are now considered for high-dose therapy (HDT) supported by autologous stem cell transplantation (ASCT). ASCT is feasible in selected elderly patients with multiple myeloma and those with non-Hodgkin's lymphoma. As elderly patients have generally been excluded from randomized studies evaluating efficacy of ASCT in comparison with non-transplant approaches, limited data are available on the efficacy of ASCT in this patient population. Recent developments in supportive care including amifostine and palifermin may increase feasibility of ASCT in elderly patients. Prospective studies are needed to evaluate feasibility and efficacy of ASCT in patients over 60 years of age. Also, further studies are needed in order to decrease toxicity of high-dose regimens in this patient group where co-morbid conditions may modify the toxicity of HDT in a clinically significant manner.