Favorable outcomes in elderly patients undergoing high-dose therapy and autologous stem cell transplantation for non-hodgkin lymphoma

Parastoo B. Dahi, Roni Tamari, Sean M. Devlin, Molly Maloy, Valkal Bhatt, Michael Scordo, Jenna Goldberg, Andrew D. Zelenetz, Paul A. Hamlin, Matthew J. Matasar, Jocelyn Maragulia, Sergio A. Giralt, Miguel Angel Perales, Craig H. Moskowitz, Craig S. Sauter

Research output: Contribution to journalArticle

29 Scopus citations

Abstract

High-dose therapy and autologous stem cell transplantation (HDT-ASCT) can offer potential long-term remission or cure in patients with non-Hodgkin lymphoma (NHL). Limited experience is available on the safety and efficacy of HDT-ASCT in elderly patients. This is a single-center, retrospective study examining outcomes of HDT-ASCT for 202 NHL patients, ages 60 years and older, between January 2001 and December 2012. Overall survival (OS) and progression-free survival (PFS) were analyzed according to age at HDT-ASCT, hematopoietic cell transplantation comorbidity index (HCT-CI), NHL histology, and remission status at the time of HDT-ASCT. The median age was 65 years (range, 60 to 74) and the majority had either diffuse large Bcell lymphoma (n= 73, 37%) or mantle cell lymphoma (n= 69, 34%). One hundred and fifteen patients (57%) had high HCT-CI scores at the time of HDT-ASCT. With a median follow-up of 3.6 years (range, 4 to 11.9 years) for survivors, PFS and OS at 3 years were 60% (95% confidence interval [CI], 53% to 68%) and 73% (95% CI, 67% to 80%), respectively. Transplantation-related mortality (TRM) was 4% both at 100 days and at 1 year after HDT-ASCT. Age and HCT-CI score were not associated with OS or PFS, and high HCT-CI did not correlate with TRM. Seven patients (4%) developed secondary myelodysplastic syndrome or acute myeloid leukemia at a median of 35 months (range, 6 to 48) after HDT-ASCT. In this single-center cohort of elderly patients with NHL undergoing HDT-ASCT, this intervention was proven tolerable and effective, with results similar to those of historic controls in younger patients. Our data suggest that age alone should not preclude HDT-ASCT in elderly patients.

Original languageEnglish (US)
Pages (from-to)2004-2009
Number of pages6
JournalBiology of Blood and Marrow Transplantation
Volume20
Issue number12
DOIs
StatePublished - Dec 1 2014
Externally publishedYes

Keywords

  • Autologous transplantation
  • Elderly
  • Non-Hodgkin lymphoma

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Fingerprint Dive into the research topics of 'Favorable outcomes in elderly patients undergoing high-dose therapy and autologous stem cell transplantation for non-hodgkin lymphoma'. Together they form a unique fingerprint.

  • Cite this

    Dahi, P. B., Tamari, R., Devlin, S. M., Maloy, M., Bhatt, V., Scordo, M., Goldberg, J., Zelenetz, A. D., Hamlin, P. A., Matasar, M. J., Maragulia, J., Giralt, S. A., Perales, M. A., Moskowitz, C. H., & Sauter, C. S. (2014). Favorable outcomes in elderly patients undergoing high-dose therapy and autologous stem cell transplantation for non-hodgkin lymphoma. Biology of Blood and Marrow Transplantation, 20(12), 2004-2009. https://doi.org/10.1016/j.bbmt.2014.08.019