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Autografting

Outcomes of auto-SCT for lymphoma in subjects aged 70 years and over

Bone Marrow Transplantation volume 46, pages 1219–1225 (2011)Cite this article

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Abstract

The safety and efficacy of auto-SCT for lymphoma in older patients is not well established, particularly in those ⩾70 years old. We performed a retrospective analysis comparing 17 auto-SCT recipients ⩾70 years old with 39 recipients aged 65–69 years. Hematopoietic cell transplantation comorbidity index (HCT-CI) scores were similar in both groups. Nonrelapse mortality (NRM) was increased in patients aged 70 years and older (hazard ratio (HR) 6.04, P=0.0029), and OS was decreased (HR 1.98, P=0.082). 1-year NRM was 35% in patients aged ⩾70 years vs 8% in those aged 65–69 years (P=0.017). The incidence of in-hospital falls was higher in those aged ⩾70 years (29 vs 8%, P=0.047). In a secondary exploratory analysis, we found that the occurrence of in-hospital falls was strongly associated with inferior OS (HR 3.36, P=0.0023) and NRM (HR 4.60, P=0.009) among all patients of aged 65 years and older. We conclude that auto-SCT is feasible in older patients but that mortality rates appear increased in those over age of 70 years. In-hospital falls were correlated with higher mortality, and prevention of falls may improve outcomes. Susceptibility to falls may indicate underlying frailty and should be explored prospectively as a means of selecting older patients for auto-SCT.

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Acknowledgements

The authors thank the patients described in this report, as well as the physicians, nurses and other health care professionals who cared for them. Special thanks to Jennifer Goldstein, MD and Shirley Fisher, RN for assistance with data collection. DJA is supported by an American Society of Clinical Oncology Young Investigator Award. MC is supported by a Bureau of Health Professionals Geriatric Training Grant for Physicians (Health Resources and Services Administration, Grant number HRO8790).

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Authors and Affiliations

  1. Division of Hematology and Oncology, UCLA Medical Center, Los Angeles, CA, USA

    D J Andorsky, M Cohen, A Naeim & L Pinter-Brown

  2. Division of Geriatrics, UCLA Medical Center, Los Angeles, CA, USA

    M Cohen

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Correspondence to L Pinter-Brown.

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Andorsky, D., Cohen, M., Naeim, A. et al. Outcomes of auto-SCT for lymphoma in subjects aged 70 years and over. Bone Marrow Transplant 46, 1219–1225 (2011). https://doi.org/10.1038/bmt.2010.289

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