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.

  • Correspondence
  • Published:

Long-term outcomes of older patients with relapsed/refractory NHL referred to ASCT

Bone Marrow Transplantation volume 56, pages 709–712 (2021)Cite this article

Subjects

Although the median age of patients is >60 years for most subtypes of lymphoma, older patients have been underrepresented in randomized clinical trials studying autologous stem cell transplantation (ASCT) and in most of these studies, only patients with aggressive lymphomas have been included [1,2,3,4]. On the other hand, retrospective studies focusing on older patients undergoing ASCT have generally neglected the population of patients included to ASCT programs who did not actually receive transplant for various reasons [5,6,7,8,9], therefore, the true benefit from inclusion to transplant program might be overestimated. Furthermore, these studies tend to have relatively short median follow-up.

From 2006 to 2016, 114 patients with various NHL diagnoses and relapsed/refractory (R/R) disease were referred for ASCT to the General University Hospital, Prague. Patients were identified through records of weekly transplantation group meetings. Both patients treated previously in General University Hospital (79%) and referred from other hospitals (21%) were included. This study was a part of the analysis of Czech Lymphoma Study Group Database NiHiL (NCT03199066) and was approved by the institutional review board. All patients signed an informed consent with data collection and processing. Survival data were collected up until 31st December 2019.

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

Fig. 1: Survival curves.

References

  1. Gisselbrecht C, Glass B, Mounier N, Singh Gill D, Linch DC, Trneny M, et al. Salvage regimens with autologous transplantation for relapsed large B-cell lymphoma in the rituximab era. J Clin Oncol. 2010;28:4184–90.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Crump M, Kuruvilla J, Couban S, MacDonald DA, Kukreti V, Kouroukis CT, et al. Randomized comparison of gemcitabine, dexamethasone, and cisplatin versus dexamethasone, cytarabine, and cisplatin chemotherapy before autologous stem-cell transplantation for relapsed and refractory aggressive lymphomas: NCIC-CTG LY.12. J Clin Oncol. 2014;32:3490–6.

    Article  CAS  PubMed  Google Scholar 

  3. Davison K, Chen BE, Kukreti V, Couban S, Benger A, Berinstein NL, et al. Treatment outcomes for older patients with relapsed/refractory aggressive lymphoma receiving salvage chemotherapy and autologous stem cell transplantation are similar to younger patients: a subgroup analysis from the phase III CCTG LY.12 trial. Ann Oncol. 2017;28:622–7.

    Article  CAS  PubMed  Google Scholar 

  4. van Imhoff GW, McMillan A, Matasar MJ, Radford J, Ardeshna KM, Kuliczkowski K, et al. Ofatumumab versus rituximab salvage chemoimmunotherapy in relapsed or refractory diffuse large B-cell lymphoma: the ORCHARRD study. J Clin Oncol. 2017;35:544–51.

    Article  PubMed  Google Scholar 

  5. Jantunen E, Canals C, Rambaldi A, Ossenkoppele G, Allione B, Blaise D, et al. Autologous stem cell transplantation in elderly patients (> or =60 years) with diffuse large B-cell lymphoma: an analysis based on data in the European Blood and Marrow Transplantation registry. Haematologica. 2008;93:1837–42.

    Article  PubMed  Google Scholar 

  6. Elstrom RL, Martin P, Hurtado Rua S, Shore TB, Furman RR, Ruan J, et al. Autologous stem cell transplant is feasible in very elderly patients with lymphoma and limited comorbidity. Am J Hematol. 2012;87:433–5.

    Article  PubMed  Google Scholar 

  7. Chihara D, Izutsu K, Kondo E, Sakai R, Mizuta S, Yokoyama K, et al. High-dose chemotherapy with autologous stem cell transplantation for elderly patients with relapsed/refractory diffuse large B cell lymphoma: a nationwide retrospective study. Biol Blood Marrow Transpl. 2014;20:684–9.

    Article  CAS  Google Scholar 

  8. Dahi PB, Tamari R, Devlin SM, Maloy M, Bhatt V, Scordo M, et al. Favorable outcomes in elderly patients undergoing high-dose therapy and autologous stem cell transplantation for non-Hodgkin lymphoma. Biol Blood Marrow Transpl. 2014;20:2004–9.

    Article  Google Scholar 

  9. Sun L, Li S, El-Jawahri A, Armand P, Dey BR, Fisher DC, et al. Autologous stem cell transplantation in elderly lymphoma patients in their 70s: outcomes and analysis. Oncologist. 2018;23:624–30.

    Article  PubMed  Google Scholar 

  10. Cheson BD, Fisher RI, Barrington SF, Cavalli F, Schwartz LH, Zucca E, et al. Recommendations for initial evaluation, staging, and response assessment of Hodgkin and non-Hodgkin lymphoma: the Lugano classification. J Clin Oncol. 2014;32:3059–68.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Sorror ML, Maris MB, Storb R, Baron F, Sandmaier BM, Maloney DG, et al. Hematopoietic cell transplantation (HCT)-specific comorbidity index: a new tool for risk assessment before allogeneic HCT. Blood. 2005;106:2912–9.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Belada D, Trněný M, editors, Diagnostic and treatment procedures in patients with malignant lymphomas. 10th ed., Czech Lymphoma Study Group; 2018. https://www.lymphoma.cz/_uploads/attachments/KLS_guidelines_10_2018_3.pdf.

  13. Graf SA, Vaughn JE, Chauncey TR, Storer BE, Gopal AK, Holmberg LA, et al. Comorbidities, alcohol use disorder, and age predict outcomes after autologous hematopoietic cell transplantation for lymphoma. Biol Blood Marrow Transpl. 2016;22:1582–7.

    Article  Google Scholar 

Download references

Acknowledgements

This study was supported exclusively by grant of Czech Ministry of Public Health AZV16-310092A.

Author information

Authors and Affiliations

  1. Department of Cell Therapy, Institute of Haematology and Blood Transfusion, Prague, Czech Republic

    Robert Pytlík

  2. 1st Department of Medicine - hematology, 1st Medical Faculty, Charles University, and General University Hospital, Prague, Czech Republic

    Robert Pytlík, Blanka Vacková, Eva Konířová, Marie Trnková, Petra Blahovcová, David Pohlreich, Kamila Polgárová, Pavel Klener Jr., Kateřina Benešová & Marek Trněný

  3. Institute of Pathological Physiology and Experimental Hematology, 1st Medical Faculty, Charles University, Prague, Czech Republic

    Pavel Klener Jr.

  4. Department of Oncology, University Hospital Motol, Prague, Czech Republic

    Kateřina Kopečková

  5. Department of Oncology, Hospital České Budějovice, České Budějovice, Czech Republic

    Jan Pirnos

Authors
  1. Robert Pytlík
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Blanka Vacková
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Eva Konířová
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marie Trnková
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Petra Blahovcová
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. David Pohlreich
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kamila Polgárová
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Pavel Klener Jr.
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Kateřina Benešová
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Kateřina Kopečková
    View author publications

    You can also search for this author in PubMed Google Scholar

  11. Jan Pirnos
    View author publications

    You can also search for this author in PubMed Google Scholar

  12. Marek Trněný
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert Pytlík.

Ethics declarations

Conflict of interest

The authors declare that they have no conflict of interest.

Additional information

Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Pytlík, R., Vacková, B., Konířová, E. et al. Long-term outcomes of older patients with relapsed/refractory NHL referred to ASCT. Bone Marrow Transplant 56, 709–712 (2021). https://doi.org/10.1038/s41409-020-01045-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/s41409-020-01045-4

Search

Advanced search

Quick links