Peripheral blood stem cell transplantation in patients over 65 years old with malignant lymphoma--possibility of early completion of chemotherapy and improvement of performance status.

OBJECTIVE: After the initial clinical application of peripheral blood stem cell transplantation (PBSCT) in the latter half of the 1980s, the frequency of PBSCT for non-Hodgkin's lymphoma (NHL) has been gradually increasing. At present, PBSCT is an important procedure for treating young patients with NHL. This procedure is now being increasingly used as a part of the chemotherapy regimen for elderly patients. We evaluated the feasibility of PBSCT in elderly patients with malignant lymphoma. PATIENTS AND METHODS: We performed PBSCT on four older patients over 65 years old (median age 71, range 66-78) with aggressive non-Hodgkin's lymphoma. Patients were initially treated with the THP-COP [cyclophosphamide, THP-doxorubicin (pirarubicin), vincristine, prednisolone] regimen as first-line chemotherapy. As second-line chemotherapy, in partial response (PR) cases, we performed PBSCT. Conditioning therapy was the MCVC [ranimustine (MCNU), carboplatin, etoposide (VP-16), cyclophosphamide] protocol.
RESULTS: PBSC collection and transplantation were possible in all patients. We observed no severe toxicity. Two of the four patients attained complete remission (CR). Tumor size was clearly diminished in two PR patients. Performance status (PS) was improved in three of the four patients after transplantation.
CONCLUSION: Despite the small number of cases, this procedure is beneficial for completing chemotherapy earlier and promoting a good quality of life.