Feasibility and toxicity of high-dose chemotherapy supported by peripheral blood stem cell transplantation in elderly patients (>/=60 years) with non-Hodgkin's lymphoma: comparison with patients <60 years treated within the same protocol.
Limited data are available concerning feasibility and toxicity of progenitor cell mobilization and high-dose therapy (HDT) supported by peripheral blood stem cell transplantation (PBSCT) in elderly patients (>/=60 years) with non-Hodgkin's lymphoma (NHL). From 1995 to 1999, 17 elderly NHL patients (median age 63 years, range 60-70) entered our HDT program and were mobilized with CY (4 g/m2) followed by G-CSF. Mobilization was successful in 13 patients, who then received BEAM or BEAC followed by PBSCT. The feasibility and toxicity of progenitor cell mobilization and HDT in the elderly patients were compared with experiences in 62 NHL patients <60 years (median 46 years, range 16-59), who received the same mobilization protocol and of whom 48 patients received HDT supported by PBSCT. No significant differences were observed between these groups in the success rate of progenitor cell mobilization, in the number of CD34-positive cells collected or in the number of aphereses needed. HDT appeared to be somewhat more toxic in the elderly patients: a higher peak CRP value (P = 0.08) and longer in-hospital stay (P = 0. 05) were observed. No differences were found in transplant-related mortality or severe organ toxicity between these age groups except for oral mucositis grade >2, which tended to be more common in the elderly patients (P = 0.07). We conclude that progenitor cell mobilization and HDT supported by PBSCT is also feasible in selected elderly patients with NHL. Bone Marrow Transplantation (2000) 26, 737-741.
Jantunen
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Department of Medicine, Kuopio University Hospital, Kuopio, Finland.
Mahlamäki
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E
Nousiainen
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T
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000592:standards* / Q000627:therapeutic use / Q000633:toxicity; D002330:Carmustine / Q000008:administration & dosage / Q000633:toxicity; D003520:Cyclophosphamide / Q000008:administration & dosage / Q000633:toxicity; D003561:Cytarabine / Q000008:administration & dosage / Q000633:toxicity; D018450:Disease Progression; D005047:Etoposide / Q000008:administration & dosage / Q000633:toxicity; D005260:Female; D006085:Graft Survival / Q000187:drug effects; D019650:Hematopoietic Stem Cell Mobilization; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D007239:Infections / Q000139:chemically induced; D008228:Lymphoma, Non-Hodgkin / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000008:administration & dosage / Q000633:toxicity; D008875:Middle Aged; D011034:Podophyllotoxin / Q000008:administration & dosage / Q000633:toxicity; D015996:Survival Rate; D013997:Time Factors; D019172:Transplantation Conditioning
D018952:Antigens, CD34; D003561:Cytarabine; D005047:Etoposide; D003520:Cyclophosphamide; D011034:Podophyllotoxin; D008558:Melphalan; D002330:Carmustine