title: High-dose chemotherapy and autologous hematopoietic progenitor cell transplantation for non-Hodgkin's lymphoma in patients >65 years of age.
abstract: METHODS
  We present a retrospective analysis of 99 consecutive patients with relapsed non-Hodgkin's lymphomas who were older than 65 years at the time of high-dose chemotherapy and autologous progenitor cell transplantation.
  
  
  RESULTS
  Median age at transplant was 68 years (range 65-82). Thirty-six percent of patients had a hematopoietic cell transplantation comorbidity index of >2 at the time of transplantation. The cumulative nonrelapse mortality was 8% [95% confidence interval (CI) 4-17] at 26 months and the 3-year overall survival (OS) was 61% (95% CI 49-71). On multivariate analysis, disease status at transplant and lactate dehydrogenase (LDH) > normal were significant predictors for OS (P = 0.002). Comorbidity index of >2 did not impact OS but did predict for higher risk of developing grade 3-5 toxicity (P = 0.006). Eight patients developed secondary myelodysplastic syndrome/acute myelogenous leukemia after transplantation (cumulative incidence 16%).
  
  
  CONCLUSIONS
  Patients with relapsed lymphomas who are >65 years of age should be considered transplant candidates, particularly if they have chemosensitive disease and normal LDH levels at the time of transplantation. Patients with comorbidity index of >2 can also undergo transplantation with acceptable outcomes but may be at higher risk for developing toxicity.
authors.affiliation: Department of Stem Cell Transplantation and Cellular Therapy, The University of Texas M. D. Anderson Cancer Center, Houston, TX 77030, USA. cmhosing@mdanderson.org
authors.forename: C
authors.initials: C
authors.lastname: Hosing
authors.forename: R M
authors.initials: RM
authors.lastname: Saliba
authors.forename: G-J
authors.initials: GJ
authors.lastname: Okoroji
authors.forename: U
authors.initials: U
authors.lastname: Popat
authors.forename: D
authors.initials: D
authors.lastname: Couriel
authors.forename: T
authors.initials: T
authors.lastname: Ali
authors.forename: L
authors.initials: L
authors.lastname: De Padua Silva
authors.forename: P
authors.initials: P
authors.lastname: Kebriaei
authors.forename: A
authors.initials: A
authors.lastname: Alousi
authors.forename: M
authors.initials: M
authors.lastname: De Lima
authors.forename: M
authors.initials: M
authors.lastname: Qazilbash
authors.forename: P
authors.initials: P
authors.lastname: Anderlini
authors.forename: S
authors.initials: S
authors.lastname: Giralt
authors.forename: R E
authors.initials: RE
authors.lastname: Champlin
authors.forename: I
authors.initials: I
authors.lastname: Khouri
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality / Q000628:therapy*; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D012189:Retrospective Studies; D014182:Transplantation, Autologous