Abstract
To evaluate autologous stem cell transplant (ASCT) in older patients with intermediate grade non-Hodgkin's lymphoma (NHL), the Mayo Clinic Rochester BMT database was reviewed for all patients 60 years of age and older who received ASCT for NHL between September 1995 and February 2003. Factors evaluated included treatment-related mortality (TRM), event-free survival (EFS) and overall survival (OS). Ninety-three patients were identified, including twenty-four (26%) over the age of 70 years. Treatment-related mortality (5.4%) was not significantly different when compared to a younger cohort (2.2%). At a median follow-up of 14 months (0.6–87.6 months), the estimated median survival is 25 months (95% confidence interval (CI) 12–38) in the older group compared to 56 months (95% CI 37–75) (P=0.037) in the younger group. The estimated 4-year EFS was 38% for the older group compared to 42% in the younger cohort (P=0.1). By multivariate analysis, the only factor found to influence survival in the older group was age-adjusted International Prognostic Index at relapse, 0–1 better than 2–3 (P=0.03). Autologous stem-cell transplant can be safely performed in patients 60 years or older with chemotherapy sensitive relapsed or first partial remission NHL. The outcome may not be different from that of younger patients in terms of TRM and EFS.
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References
National Cancer Institute D. Surveillance research programe, cancer statistics branch. SEER program public-use data. Available at: http://seer.cancer.gov, 2003.
Jemal A, Murray T, Samuels A, Ghafoor A, Ward E, Thun MJ . Cancer statistics, 2003. CA Cancer J Clin 2003; 53: 5–26.
The International Non-Hodgkin's Lymphoma Prognostic Factors Project. A predictive model for aggressive non-Hodgkin's lymphoma. N Engl J Med 1993; 329: 987–994.
Jones SE, Fuks Z, Bull M, Kadin ME, Dorfman RF, Kaplan HS et al. Non-Hodgkin's lymphomas. IV. Clinicopathologic correlation in 405 cases. Cancer 1973; 31: 806–823.
Carbone A, Volpe R, Gloghini A, Trovo M, Zagonel V, Tirelli U et al. Non-Hodgkin's lymphoma in the elderly. I. Pathologic features at presentation. Cancer 1990; 66: 1991–1994.
Barnes N, Cartwright RA, O'Brien C, Roberts B, Richards ID, Hopkinson JM et al. Variation in lymphoma incidence within Yorkshire Health Region. Br J Cancer 1987; 55: 81–84.
Coiffier B, Lepage E, Briere J, Herbrecht R, Tilly H, Bouabdallah R et al. CHOP chemotherapy plus rituximab compared with CHOP alone in elderly patients with diffuse large-B-cell lymphoma. N Engl J Med 2002; 346: 235–242.
Velasquez WS, McLaughlin P, Tucker S, Hagemeister FB, Swan F, Rodriguez MA et al. ESHAP – an effective chemotherapy regimen in refractory and relapsing lymphoma: a 4-year follow-up study. J Clin Oncol 1994; 12: 1169–1176.
Velasquez WS, Cabanillas F, Salvador P, McLaughlin P, Fridrik M, Tucker S et al. Effective salvage therapy for lymphoma with cisplatin in combination with high-dose Ara-C and dexamethasone (DHAP). Blood 1988; 71: 117–122.
Philip T, Guglielmi C, Hagenbeek A, Somers R, Van der Lelie H, Bron D et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin's lymphoma. N Engl J Med 1995; 333: 1540–1545.
Morris CL, Siegel E, Barlogie B, Cottler-Fox M, Lin P, Fassas A et al. Mobilization of CD34+ cells in elderly patients (>/=70 years) with multiple myeloma: influence of age, prior therapy, platelet count and mobilization regimen. Br J Haematol 2003; 120: 413–423.
Badros A, Barlogie B, Siegel E, Morris C, Desikan R, Zangari M et al. Autologous stem cell transplantation in elderly multiple myeloma patients over the age of 70 years. Br J Haematol 2001; 114: 600–607.
Stamatoullas A, Fruchart C, Khalfallah S, Buchonnet G, Contentin N, Bastit D 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.
Moreau P, Milpied N, Voillat L, Colombat P, Mahe B, Rapp MJ 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.
Jantunen E, Mahlamaki E, Nousiainen T . Feasibility and toxicity of high-dose chemotherapy supported by peripheral blood stem cell transplantation in elderly patients (>/=60 years) with non-Hodgkin's lymphoma: comparison with patients <60 years treated within the same protocol. Bone Marrow Transplant 2000; 26: 737–741.
Leger CS, Bredeson C, Kearns B, Bence-Bruckler I, Atkins H, Huebsch L . Autologous blood and marrow transplantation in patients 60 years and older. Biol Blood Marrow Transplant 2000; 6: 204–210.
Gopal AK, Gooley TA, Golden JB, Maloney DG, Bensinger WI, Petersdorf SH et al. Efficacy of high-dose therapy and autologous hematopoietic stem cell transplantation for non-Hodgkin's lymphoma in adults 60 years of age and older. Bone Marrow Transplant 2001; 27: 593–599.
Harris NL, Jaffe ES, Diebold J, Flandrin G, Muller-Hermelink HK, Vardiman J et al. World Health Organization classification of neoplastic diseases of the hematopoietic and lymphoid tissues: report of the Clinical Advisory Committee meeting-Airlie House, Virginia, November 1997. J Clin Oncol 1999; 17: 3835–3849.
Cheson BD, Horning SJ, Coiffier B, Shipp MA, Fisher RI, Connors JM et al. Report of an international workshop to standardize response criteria for non-Hodgkin's lymphomas. NCI Sponsored International Working Group. J Clin Oncol 1999; 17: 1244.
Kaplan E, Meier P . Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958; 53: 457–481.
Cox D . Regression models and life tables. J R Stat Soc 1972; 34: 187–220.
Fisher RI, Gaynor ER, Dahlberg S, Oken MM, Grogan TM, Mize EM et al. Comparison of a standard regimen (CHOP) with three intensive chemotherapy regimens for advanced non-Hodgkin's lymphoma. N Engl J Med 1993; 328: 1002–1006.
Miller TP, Dana BW, Weick JK, Jones SE, Coltman CA, Dahlberg S et al. Southwest Oncology Group clinical trials for intermediate- and high-grade non-Hodgkin's lymphomas. Semin Hematol 1988; 25: 17–22.
Armitage JO . Treatment of non-Hodgkin's lymphoma. N Engl J Med 1993; 328: 1023–1030.
Bitran JD, Klein L, Link D, Kosirog-Glowacki J, Stewart C, Raack D et al. High-dose myeloablative therapy and autologous peripheral blood progenitor cell transplantation for elderly patients (greater than 65 years of age) with relapsed large cell lymphoma. Biol Blood Marrow Transplant 2003; 9: 383–388.
Micallef IN, Lillington DM, Apostolidis J, Amess JA, Neat M, Matthews J et al. Therapy-related myelodysplasia and secondary acute myelogenous leukemia after high-dose therapy with autologous hematopoietic progenitor-cell support for lymphoid malignancies. J Clin Oncol 2000; 18: 947–955.
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Buadi, F., Micallef, I., Ansell, S. et al. Autologous hematopoietic stem cell transplantation for older patients with relapsed non-Hodgkin's lymphoma. Bone Marrow Transplant 37, 1017–1022 (2006). https://doi.org/10.1038/sj.bmt.1705371
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DOI: https://doi.org/10.1038/sj.bmt.1705371
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