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Quality of Life

Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience

Bone Marrow Transplantation volume 27, pages 1189–1195 (2001)Cite this article

Abstract

Between May 1994 and May 2000, we autotransplanted 48 consecutive patients, 21 females and 27 males aged over 60 years (range: 60–78, median: 63). Sixteen patients had multiple myeloma (MM), 14 high-grade non-Hodgkin's lymphoma (HGNHL), six low-grade non-Hodgkin's lymphoma (LGNHL), nine acute myeloid leukemia (AML), one chronic lymphocytic leukemia (CLL), one Hodgkin's disease (HD) and one breast cancer; the performance status (WHO) was 0–1. Seventeen patients were in 1st CR (35.4%) and one in 2nd CR (2.1%), 25 in PR (52.1%), while five patients had been transplanted with progressive disease (10.4%); seven patients with MM received a double transplant. Patients received high-dose therapy including melphalan alone (13) or associated with other drugs (26), busulfan-cyclophosphamide (three), BEAM (11) and TBI (two). All patients took a median of 11 (range: 8–25) days to reach neutrophils >500/μl, 13 (range: 9–83) days to reach platelets >20 000/μl and 17 (range: 11–83) days to reach platelets >50 000/μl. Hematological toxicity, hospital stay and supportive care did not differ from those of a cohort of younger patients. At present, 31 patients are alive (14 in CR, five in PR, five in PD and seven in relapse) and 16 died from PD at a median follow-up of 37 months (1–67). Only one patient died from transplant-related toxicity. Quality of life, evaluated using a QLQ-C30 questionnaire in 25 patients at day +90, was good. In our experience PBPC mobilization and transplantation is feasible in patients aged ⩾60 years and the toxicity of this procedure is acceptable, with an early transplant-related mortality of 1.8%; therefore patients with hematological malignancies potentially curable with high-dose therapy (HDT) should also be candidates for HDT. Bone Marrow Transplantation (2001) 27, 1189–1195.

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References

  1. Philip T, Guglielmi C, Hagenbeek A et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's Lymphoma New Engl J Med 1995 333: 1540–1545

    Article  CAS  PubMed  Google Scholar 

  2. Harousseau JL, Attal M . The role of autologous hematopoietic stem cell transplantation in multiple myeloma Semin Hematol 1997 34: (Suppl. 1) 61–66

    CAS  PubMed  Google Scholar 

  3. Freedman AS, Neuberg D, Mauch P et al. Long-term follow-up of autologous bone marrow transplantation in patients with relapsed follicular lymphoma Blood 1999 94: 3325–3333

    CAS  PubMed  Google Scholar 

  4. Linch DC, Goldstone AH . High-dose therapy for Hodgkin's disease Br J Haematol 1999 107: 685–690

    Article  CAS  PubMed  Google Scholar 

  5. Hortobagyi GN, Buzdar AU, Theriault RL et al. Randomized trial of high-dose chemotherapy and blood cell autografts for high-risk primary breast carcinoma J Natl Cancer Inst 2000 92: 225–233

    Article  CAS  PubMed  Google Scholar 

  6. Stiff P, Chen B, Franklin W et al. Autologous transplantation of ex vivo expanded bone marrow cells grown from small aliquots after high-dose chemotherapy for breast cancer Blood 2000 95: 2169–2174

    CAS  PubMed  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 21: 1193–1196

    Article  CAS  PubMed  Google Scholar 

  8. 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  PubMed  Google Scholar 

  9. 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  PubMed  Google Scholar 

  10. 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 

  11. Ciniero L, Olivieri A, Ombrosi L et al. Criopreservazione di progenitori emopietici circolanti mediante ‘uncontrolled rate freezing’: esperienza clinica preliminare. Paper presented at the XXXV Congresso SIE, Pavia, 10–13 Settembre 1995 CO84

  12. Capelli D, Santini G, De Souza C et al. Amifostine can reduce mucosal damage after high-dose melphalan conditioning for peripheral blood progenitor cell autotransplant: a retrospective study Br J Haematol 2000 110: 300–307

    Article  CAS  PubMed  Google Scholar 

  13. Offidani M, Corvatta L, Olivieri A et al. Infectious complications after autologous peripheral blood progenitor cell transplantation followed by G-CSF Bone Marrow Transplant 1999 24: 1079–1087

    Article  CAS  PubMed  Google Scholar 

  14. Brundage MD, Pater JL, Zee B . Assessing the reliability of two toxicity scales: implications for interpreting toxicity data J Natl Cancer Inst 1993 85: 1138–1148

    Article  CAS  PubMed  Google Scholar 

  15. Salloum E, Jillella AP, Nadkarni R et al. Assessment of pulmonary and cardiac function after high dose chemotherapy with BEAM and peripheral blood progenitor cell transplantation Cancer 1998 82: 1506–1512

    Article  CAS  PubMed  Google Scholar 

  16. Acosta F, De La Morena G, Villegas M et al. Evaluation of cardiac function before and after liver transplantation Transplant Proc 1999 31: 2369–2370

    Article  CAS  PubMed  Google Scholar 

  17. Fulgoni P, Zoia MC, Corsico A et al. Lung function in survivors of childhood acute lymphoblastic leukemia Chest 1999 116: 1163–1167

    Article  CAS  PubMed  Google Scholar 

  18. Zittoun R, Suciu S, Watson M et al. Quality of life in patients with acute myelogenous leukemia in prolonged first complete remission after bone marrow transplantation (allogeneic or autologous) or chemotherapy: a cross-sectional study of the EORTC-GIMEMA AML 8A trial Bone Marrow Transplant 1997 20: 307–315

    Article  CAS  PubMed  Google Scholar 

  19. Wettergen L, Langius A, Björkholm M, Björvell H . Physical and psychosocial functioning in patients undergoing autologous bone marrow transplantation – a prospective study Bone Marrow Transplant 1997 20: 497–502

    Article  Google Scholar 

  20. Hjermstad MJ, Evensen SA, Kvaloy SO et al. Health-related quality of life 1 year after allogeneic or autologous stem-cell transplantation: a prospective study J Clin Oncol 1999 17: 706–718

    Article  CAS  PubMed  Google Scholar 

  21. Oken MM, Creech RH, Tormey DC et al. Toxicity and response criteria of the Eastern Cooperative Oncology Group Am J Clin Oncol 1982 5: 649–655

    Article  CAS  PubMed  Google Scholar 

  22. Olivieri A, Offidani M, Montanari M et al. Factors affecting hemopoietic recovery after high-dose therapy and autologous peripheral blood progenitor cell transplantation: a single center experience Haematologica 1998 83: 329–337

    CAS  PubMed  Google Scholar 

  23. Tirelli U, Errante D, Van Glabbeke M et al. CHOP is the standard regimen in patients > or =70 years of age with intermediate-grade and high-grade non-Hodgkin's Lymphoma: results of a randomized study of the European Organization for Research and Treatment of Cancer Lymphoma Cooperative Study Group J Clin Oncol 1998 16: 27–34

    Article  CAS  PubMed  Google Scholar 

  24. Kusnierz-Glaz CR, Schlegel PG, Wong RM et al. Influence of age on the outcome of 500 autologous bone marrow procedures for hematologic malignancies J Clin Oncol 1997 15: 18–25

    Article  CAS  PubMed  Google Scholar 

  25. 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  PubMed  Google Scholar 

  26. 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 

  27. 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 

  28. Olivieri A, Corvatta L, Montanari M et al. Paroxysmal atrial fibrillation after high-dose melphalan in five patients autotransplanted with blood progenitor cells Bone Marrow Transplant 1998 21: 1049–1053

    Article  CAS  PubMed  Google Scholar 

  29. Shipp MA . Prognostic factors in non-Hodgkin's lymphoma Curr Opin Oncol 1992 4: 856–862

    Article  CAS  PubMed  Google Scholar 

  30. Shipp MA . Prognostic factors in aggressive non-Hodgkin's Lymphoma: who has ‘high-risk’ disease? Blood 1994 83: 1165–1173

    CAS  PubMed  Google Scholar 

  31. Bosly A, Coiffier B, Gisselbrecht C et al. Bone marrow transplantation prolongs survival after relapse in aggressive lymphoma patients treated with LNH-84 regimen J Clin Oncol 1992 10: 1615–1623

    Article  CAS  PubMed  Google Scholar 

  32. Blade J . Therapeutic strategies and controversies in the treatment of multiple myeloma Pathol Biol (Paris) 1999 47: 192–198

    CAS  Google Scholar 

  33. Zittoun RA, Mandelli F, Willemze R et al. Autologous or allogeneic bone marrow transplantation compared with intensive chemotherapy in acute myelogenous leukemia. European Organization for Research and Treatment of Cancer (EORTC) and the Gruppo Italiano Malattie Ematologiche Maligne dell'Adulto (GIMEMA) Leukemia Cooperative Groups New Engl J Med 1995 332: 217–223

    Article  CAS  PubMed  Google Scholar 

  34. Cassileth PA, Harrington DP, Appelbaum FR et al. Chemotherapy compared with autologous or allogeneic bone marrow transplantation in the management of acute myeloid leukemia in first remission New Engl J Med 1998 339: 1649–1656

    Article  CAS  PubMed  Google Scholar 

  35. Löwenberg B, Sonneveld P . Resistance to chemotherapy in acute leukemia Curr Opin Oncol 1998 10: 31–35

    Article  PubMed  Google Scholar 

  36. Rowe JM . Treatment of acute myelogenous leukemia in older adults Leukemia 2000 14: 480–487

    Article  CAS  PubMed  Google Scholar 

  37. Balducci L, Extermann M . Cancer chemotherapy in the older patient Cancer 1997 80: 1317–1324

    Article  CAS  PubMed  Google Scholar 

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Acknowledgements

We wish to thank Mr David Massey and Mrs Cinzia Gaggiotti for support in the correction of the manuscript. The research was supported by MURST (40%) and Italian Association against Leukemia (60%).

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Authors and Affiliations

  1. Hematology Department, University of Ancona, Italy

    A Olivieri, D Capelli, M Montanari, M Brunori, D Massidda, A Poloni, M Lucesole, MC Masia, C Tonnini & P Leoni

  2. Internal Medicine Division, Civitanova Marche Hospital, Italy

    R Centurioni

  3. Internal Medicine Department, University of Ancona, Italy

    M Candela

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Olivieri, A., Capelli, D., Montanari, M. et al. Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience. Bone Marrow Transplant 27, 1189–1195 (2001). https://doi.org/10.1038/sj.bmt.1703034

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