PURPOSE: To determine the effect of age on the outcome of autologous bone marrow transplantation (ABMT) and/or peripheral-blood progenitor-cell (PBPC) transplantation. PATIENTS AND METHODS: A retrospective analysis was performed on 500 consecutive patients who ranged in age from 1 to 65 years (median, 40) with non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD), multiple myeloma (MM), or acute nonlymphoblastic leukemia (AML) who underwent autologous hematopoietic-cell transplant procedures at Stanford University Medical Center. RESULTS: The actuarial 5-year event-free survival (EFS) rate was 44%, the relapse rate 47%, and the regimen-related mortality (RRM) rate 8.6%. Disease status at time of transplantation, categorized as either minimal or advanced disease, was the strongest predictive factor for EFS (relative risk (RR) for advanced-disease group, 1.8; P < .0003) and relapse rate (RR for advanced-disease group, 1.9; P < .0004). Patients with minimal or advanced disease had an EFS rate of 48% and 30% and relapse rates of 43% and 72%, respectively. The EFS rate of patients less than 50 years verus > or = 50 years of age was 46% versus 34% (P = .03). Cox regression analysis showed that age was predictive for EFS (RR for patients 50 to 65 years, 1.4; P = .03). The actuarial RRM rate for these age groups was 7.4% versus 12.7% (P = .07), respectively. Multivariate analysis demonstrated that age (odds ratio [OR] for patients 50 to 65 years, 1.9; P < .05) and period of transplantation (OR for most recent years [1991 to 1995], 0.6; P = .06) were the most predictive factors for RRM. CONCLUSION: Although age greater than 50 years is associated with an inferior outcome following autologous hematopoietic-cell transplantation, it does not appear to be warranted to limit this potentially curative procedure based solely on age. The upper age limit of high-dose therapy with autologous progenitor-cell and/ or bone marrow support remains to be defined.
PURPOSE: To determine the effect of age on the outcome of autologous bone marrow transplantation (ABMT) and/or peripheral-blood progenitor-cell (PBPC) transplantation. PATIENTS AND METHODS: A retrospective analysis was performed on 500 consecutive patients who ranged in age from 1 to 65 years (median, 40) with non-Hodgkin's lymphoma (NHL), Hodgkin's disease (HD), multiple myeloma (MM), or acute nonlymphoblastic leukemia (AML) who underwent autologous hematopoietic-cell transplant procedures at Stanford University Medical Center. RESULTS: The actuarial 5-year event-free survival (EFS) rate was 44%, the relapse rate 47%, and the regimen-related mortality (RRM) rate 8.6%. Disease status at time of transplantation, categorized as either minimal or advanced disease, was the strongest predictive factor for EFS (relative risk (RR) for advanced-disease group, 1.8; P < .0003) and relapse rate (RR for advanced-disease group, 1.9; P < .0004). Patients with minimal or advanced disease had an EFS rate of 48% and 30% and relapse rates of 43% and 72%, respectively. The EFS rate of patients less than 50 years verus > or = 50 years of age was 46% versus 34% (P = .03). Cox regression analysis showed that age was predictive for EFS (RR for patients 50 to 65 years, 1.4; P = .03). The actuarial RRM rate for these age groups was 7.4% versus 12.7% (P = .07), respectively. Multivariate analysis demonstrated that age (odds ratio [OR] for patients 50 to 65 years, 1.9; P < .05) and period of transplantation (OR for most recent years [1991 to 1995], 0.6; P = .06) were the most predictive factors for RRM. CONCLUSION: Although age greater than 50 years is associated with an inferior outcome following autologous hematopoietic-cell transplantation, it does not appear to be warranted to limit this potentially curative procedure based solely on age. The upper age limit of high-dose therapy with autologous progenitor-cell and/ or bone marrow support remains to be defined.
Authors: K Kohda; S Sakamaki; T Matsunaga; T Kuga; A Fujimi; Y Konuma; T Kusakabe; K Kogawa; T Akiyama; K Koike; Y Hirayama; Y Sasagawa; S Nojiri; Y Hirata; T Nishisato; G Y Niitsu Journal: Int J Hematol Date: 2001-02 Impact factor: 2.490
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: Manish Sharma; Mei-Jie Zhang; Xiaobo Zhong; Muneer H Abidi; Görgün Akpek; Ulrike Bacher; Natalie S Callander; Angela Dispenzieri; César O Freytes; Henry C Fung; Robert Peter Gale; Cristina Gasparetto; John Gibson; Leona A Holmberg; Tamila L Kindwall-Keller; Thomas R Klumpp; Amrita Y Krishnan; Heather J Landau; Hillard M Lazarus; Sagar Lonial; Angelo Maiolino; David I Marks; Paulette Mehta; Joseph R Mikhael Med; Taiga Nishihori; Richard Olsson; Muthalagu Ramanathan; Vivek Roy; Bipin N Savani; Harry C Schouten; Emma Scott; Jason Tay; Luen Bik To; David H Vesole; Dan T Vogl; Parameswaran Hari Journal: Biol Blood Marrow Transplant Date: 2014-07-18 Impact factor: 5.742