PATIENTS AND METHODS: We present a retrospective analysis of 99 consecutive patients with relapsed non-Hodgkin's lymphomas who were older than 65 years at the time of high-dose chemotherapy and autologous progenitor cell transplantation. RESULTS: Median age at transplant was 68 years (range 65-82). Thirty-six percent of patients had a hematopoietic cell transplantation comorbidity index of >2 at the time of transplantation. The cumulative nonrelapse mortality was 8% [95% confidence interval (CI) 4-17] at 26 months and the 3-year overall survival (OS) was 61% (95% CI 49-71). On multivariate analysis, disease status at transplant and lactate dehydrogenase (LDH) > normal were significant predictors for OS (P = 0.002). Comorbidity index of >2 did not impact OS but did predict for higher risk of developing grade 3-5 toxicity (P = 0.006). Eight patients developed secondary myelodysplastic syndrome/acute myelogenous leukemia after transplantation (cumulative incidence 16%). CONCLUSIONS: Patients with relapsed lymphomas who are >65 years of age should be considered transplant candidates, particularly if they have chemosensitive disease and normal LDH levels at the time of transplantation. Patients with comorbidity index of >2 can also undergo transplantation with acceptable outcomes but may be at higher risk for developing toxicity.
PATIENTS AND METHODS: We present a retrospective analysis of 99 consecutive patients with relapsed non-Hodgkin's lymphomas who were older than 65 years at the time of high-dose chemotherapy and autologous progenitor cell transplantation. RESULTS: Median age at transplant was 68 years (range 65-82). Thirty-six percent of patients had a hematopoietic cell transplantation comorbidity index of >2 at the time of transplantation. The cumulative nonrelapse mortality was 8% [95% confidence interval (CI) 4-17] at 26 months and the 3-year overall survival (OS) was 61% (95% CI 49-71). On multivariate analysis, disease status at transplant and lactate dehydrogenase (LDH) > normal were significant predictors for OS (P = 0.002). Comorbidity index of >2 did not impact OS but did predict for higher risk of developing grade 3-5 toxicity (P = 0.006). Eight patients developed secondary myelodysplastic syndrome/acute myelogenous leukemia after transplantation (cumulative incidence 16%). CONCLUSIONS:Patients with relapsed lymphomas who are >65 years of age should be considered transplant candidates, particularly if they have chemosensitive disease and normal LDH levels at the time of transplantation. Patients with comorbidity index of >2 can also undergo transplantation with acceptable outcomes but may be at higher risk for developing toxicity.
Authors: F K Buadi; I N Micallef; S M Ansell; L F Porrata; A Dispenzieri; M A Elliot; D A Gastineau; M A Gertz; M Q Lacy; M R Litzow; A Tefferi; D J Inwards Journal: Bone Marrow Transplant Date: 2006-06 Impact factor: 5.483
Authors: E Jantunen; M Itälä; E Juvonen; S Leppä; L Keskinen; K Vasala; K Remes; T Wiklund; E Elonen; T Nousiainen Journal: Bone Marrow Transplant Date: 2006-02 Impact factor: 5.483
Authors: Mohamed L Sorror; Michael B Maris; Rainer Storb; Frederic Baron; Brenda M Sandmaier; David G Maloney; Barry Storer Journal: Blood Date: 2005-06-30 Impact factor: 22.113
Authors: A Olivieri; D Capelli; M Montanari; M Brunori; D Massidda; A Poloni; M Lucesole; R Centurioni; M Candela; M C Masia; C Tonnini; P Leoni Journal: Bone Marrow Transplant Date: 2001-06 Impact factor: 5.483
Authors: A K Gopal; T A Gooley; J B Golden; D G Maloney; W I Bensinger; S H Petersdorf; F R Appelbaum; O W Press Journal: Bone Marrow Transplant Date: 2001-03 Impact factor: 5.483
Authors: Issa F Khouri; Rima M Saliba; Chitra Hosing; Grace-Julia Okoroji; Sandra Acholonu; Paolo Anderlini; Daniel Couriel; Marcos De Lima; Michele L Donato; Luis Fayad; Segio Giralt; Roy Jones; Martin Korbling; Farzaneh Maadani; John T Manning; Barbara Pro; Elizabeth Shpall; Anas Younes; Peter McLaughlin; Richard E Champlin Journal: J Clin Oncol Date: 2005-04-01 Impact factor: 44.544
Authors: Hillard M Lazarus; Jeanette Carreras; Christian Boudreau; Fausto R Loberiza; James O Armitage; Brian J Bolwell; César O Freytes; Robert Peter Gale; John Gibson; Gregory A Hale; David J Inwards; Charles F LeMaistre; Dipnarine Maharaj; David I Marks; Alan M Miller; Santiago Pavlovsky; Harry C Schouten; Koen van Besien; Julie M Vose; Jacob D Bitran; Issa F Khouri; Philip L McCarthy; Hongmei Yu; Philip Rowlings; Derek S Serna; Mary M Horowitz; J Douglas Rizzo Journal: Biol Blood Marrow Transplant Date: 2008-12 Impact factor: 5.742
Authors: Lova Sun; Shuli Li; Areej El-Jawahri; Philippe Armand; Bimalangshu R Dey; David C Fisher; Eric D Jacobsen; Caron A Jacobson; Ann S LaCasce; Steven L McAfee; Thomas R Spitzer; Yi-Bin Chen; Zachariah DeFilipp Journal: Oncologist Date: 2017-12-28
Authors: 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 Journal: Biol Blood Marrow Transplant Date: 2014-08-28 Impact factor: 5.742
Authors: A Olivieri; M Marchetti; R Lemoli; C Tarella; A Iacone; F Lanza; A Rambaldi; A Bosi Journal: Bone Marrow Transplant Date: 2011-05-30 Impact factor: 5.483
Authors: S M Jaglowski; A S Ruppert; C C Hofmeister; P Elder; W Blum; R Klisovic; S Vasu; S Penza; Y A Efebera; D M Benson; S M Devine; L A Andritsos Journal: Bone Marrow Transplant Date: 2014-07-28 Impact factor: 5.483