Autologous stem cell transplantation in elderly (>60 years) patients with non-Hodgkin's lymphoma: a nation-wide analysis

• Published in: Bone marrow transplantation (Basingstoke) Vol. 37; no. 4; pp. 367 - 372
• Main Authors: JANTUNEN, E, ITÄLÄ, M, JUVONIEN, E, LEPPÄ, S, KESKINEN, L, VASALA, K, REMES, K, WIKLUND, T, ELONEN, E, NOUSIAINEN, T
• Format: Journal Article
• Language: English
• Published: Basingstoke Nature Publishing Group 01.02.2006
• Subjects: Age Factors; Aged; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Autografts; Biological and medical sciences; Bone marrow, stem cells transplantation. Graft versus host reaction; Care and treatment; Disease Progression; Disease-Free Survival; Feasibility; Feasibility Studies; Female; Finland; Hematologic and hematopoietic diseases; Hematopoietic Stem Cell Transplantation - adverse effects; Histology; Hodgkin's disease; Humans; Leukemias. Malignant lymphomas. Malignant reticulosis. Myelofibrosis; Leukocytes (neutrophilic); Lymphocytes; Lymphocytes T; Lymphoma; Lymphoma, Non-Hodgkin - therapy; Male; Medical sciences; Middle Aged; Mortality; Non-Hodgkin's lymphoma; Older people; Patients; Platelets; Recurrence; Remission; Risk factors; Stem cell transplantation; Stem cells; Survival Rate; Transfusions. Complications. Transfusion reactions. Cell and gene therapy; Transplantation; Transplantation Conditioning - methods; Transplantation, Autologous; Treatment Outcome; Finland; Human; elderly patients; Hematology; Stem cell; Mortality; autologous stem cell transplantation; Hematopoietic cell; Malignant hemopathy; Non Hodgkin lymphoma; treatment-related mortality; Autograft; Treatment; non- Hodgkin's lymphoma; Lymphoproliferative syndrome; Graft; Elderly
• ISSN: 0268-3369; 1476-5365
• DOI: 10.1038/sj.bmt.1705266

Limited experience is available on the feasibility and efficacy of autologous stem cell transplantation (ASCT) in elderly patients with non-Hodgkin's lymphoma (NHL). In 1994-2004 altogether 88 NHL patients > 60 years old received ASCT in six Finnish transplant centres. There were 57 male and 31 female patients with a median age of 63 years (range 60-70 years); 17 patients were>65 years. The histology included diffuse large B cell (n = 29), mantle cell (n = 27), follicular (n = 15), peripheral T cell (n = 12) and other (n = 5). Disease status at ASCT was I complete remission/partial remission (CR/PR) in 53 patients, II CR/PR in 30 patients and other in five patients. The conditioning regimens included BEAC (n = 49), BEAM (n = 34), TBI-CY (n = 4) and other (n = 1). Eighty-four patients received PB grafts. The medians to reach neutrophils > 0.5 and platelets > 20 were 10 and 14 days, respectively. The early treatment-related mortality (TRM) (<100 days) was 11%. With a median follow-up of 21 months for all patients, 45 patients (51%) are alive. A relapse or progression after ASCT has been observed in 32 patients (36%). ASCT is feasible in selected elderly patients with NHL, but the early TRM seems to be higher than in younger patients.