BACKGROUND: Understanding the mortality patterns of patients with lymphoma and myeloma, who have undergone autologous hematopoietic stem cell transplantation (ASCT) might identify improvement opportunities. PATIENTS AND METHODS: The present retrospective study included patients with lymphoma and myeloma, aged ≥ 18 years, who had undergone ASCT from 1983 to 2010 at the University of Nebraska Medical Center. Of the 2284 patients, 972 had died within first 5 years after ASCT. The patients were divided into 3 cohorts according to the time of transplantation: 1983 to 1990 (cohort I), 1991 to 2000 (cohort II), and 2001 to 2010 (cohort III). Using Cox proportional hazards regression analysis, the risk of cause-specific mortality was compared across the 3 cohorts. RESULTS: Of a total of 1215 deaths, 972 (80%) occurred within the first 5 years after ASCT. Disease relapse (73.4%), organ failure (7.8%), infection (4.7%), and secondary malignancy (4.2%) accounted for most of the deaths. The risk of death from infection (P < .0001), but not from relapse (P = .26), organ failure (P = .68), or secondary malignancy (P = .15), had declined in the more recent cohorts. CONCLUSION: The 5-year overall survival of patients undergoing ASCT has improved significantly owing to a decline in infectious mortality. Our results highlight that the mortality from relapse remains the most common cause of death, warranting investigation of different strategies to reduce the incidence of relapse and improve the therapy for relapse after ASCT.
BACKGROUND: Understanding the mortality patterns of patients with lymphoma and myeloma, who have undergone autologous hematopoietic stem cell transplantation (ASCT) might identify improvement opportunities. PATIENTS AND METHODS: The present retrospective study included patients with lymphoma and myeloma, aged ≥ 18 years, who had undergone ASCT from 1983 to 2010 at the University of Nebraska Medical Center. Of the 2284 patients, 972 had died within first 5 years after ASCT. The patients were divided into 3 cohorts according to the time of transplantation: 1983 to 1990 (cohort I), 1991 to 2000 (cohort II), and 2001 to 2010 (cohort III). Using Cox proportional hazards regression analysis, the risk of cause-specific mortality was compared across the 3 cohorts. RESULTS: Of a total of 1215 deaths, 972 (80%) occurred within the first 5 years after ASCT. Disease relapse (73.4%), organ failure (7.8%), infection (4.7%), and secondary malignancy (4.2%) accounted for most of the deaths. The risk of death from infection (P < .0001), but not from relapse (P = .26), organ failure (P = .68), or secondary malignancy (P = .15), had declined in the more recent cohorts. CONCLUSION: The 5-year overall survival of patients undergoing ASCT has improved significantly owing to a decline in infectious mortality. Our results highlight that the mortality from relapse remains the most common cause of death, warranting investigation of different strategies to reduce the incidence of relapse and improve the therapy for relapse after ASCT.
Authors: Anna Waszczuk-Gajda; Olaf Penack; Giulia Sbianchi; Linda Koster; Didier Blaise; Péter Reményi; Nigel Russell; Per Ljungman; Marek Trneny; Jiri Mayer; Simona Iacobelli; Guido Kobbe; Christof Scheid; Jane Apperley; Cyrille Touzeau; Stig Lenhoff; Esa Jantunen; Achilles Anagnostopoulos; Laura Paris; Paul Browne; Catherine Thieblemont; Nicolaas Schaap; Jorge Sierra; Ibrahim Yakoub-Agha; Laurent Garderet; Jan Styczynski; Helene Schoemans; Ivan Moiseev; Rafael F Duarte; Zinaida Peric; Silvia Montoto; Anja van Biezen; Malgorzata Mikulska; Mahmoud Aljurf; Tapani Ruutu; Nicolaus Kröger; Curly Morris; Christian Koenecke; Stefan Schoenland; Grzegorz W Basak Journal: J Clin Med Date: 2022-06-20 Impact factor: 4.964
Authors: Zdeněk Král; Jozef Michalka; Heidi Móciková; Jana Marková; Alice Sýkorová; David Belada; Alexandra Jungová; Samuel Vokurka; Marie Lukášová; Vít Procházka; Juraj Ďuraš; Roman Hájek; Ladislav Dušek; Ľuboš Drgoňa; Miriam Ladická; Veronika Ballová; Andrej Vranovský Journal: J Cancer Date: 2019-08-28 Impact factor: 4.207
Authors: Ramona Wullenkord; Philipp Berning; Anna-Lena Niemann; Klaus Wethmar; Sarah Bergmann; Mathias Lutz; Christoph Schliemann; Rolf Mesters; Torsten Keßler; Norbert Schmitz; Wolfgang E Berdel; Georg Lenz; Matthias Stelljes Journal: Ann Hematol Date: 2021-09-03 Impact factor: 3.673