title: Influence of age on the outcome of 500 autologous bone marrow transplant procedures for hematologic malignancies.
abstract: OBJECTIVE
  To determine the effect of age on the outcome of autologous bone marrow transplantation (ABMT) and/or peripheral-blood progenitor-cell (PBPC) transplantation.
  
  
  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.
  
  
  CONCLUSIONS
  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.affiliation: Department of Medicine, Stanford University Medical Center, CA 94305-5290, USA.
authors.forename: C R
authors.initials: CR
authors.lastname: Kusnierz-Glaz
authors.forename: P G
authors.initials: PG
authors.lastname: Schlegel
authors.forename: R M
authors.initials: RM
authors.lastname: Wong
authors.forename: J R
authors.initials: JR
authors.lastname: Schriber
authors.forename: N J
authors.initials: NJ
authors.lastname: Chao
authors.forename: M D
authors.initials: MD
authors.lastname: Amylon
authors.forename: W W
authors.initials: WW
authors.lastname: Hu
authors.forename: R S
authors.initials: RS
authors.lastname: Negrin
authors.forename: Y
authors.initials: Y
authors.lastname: Lee
authors.forename: K G
authors.initials: KG
authors.lastname: Blume
authors.forename: G D
authors.initials: GD
authors.lastname: Long
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D016026:Bone Marrow Transplantation; D002648:Child; D002675:Child, Preschool; D019337:Hematologic Neoplasms / Q000628:therapy*; D006689:Hodgkin Disease / Q000628:therapy; D006801:Humans; D007223:Infant; D015470:Leukemia, Myeloid, Acute / Q000628:therapy; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy; D008875:Middle Aged; D009101:Multiple Myeloma / Q000628:therapy; D015999:Multivariate Analysis; D012008:Recurrence; D012189:Retrospective Studies; D016896:Treatment Outcome