Influence of age and histology on outcome in adult non-Hodgkin lymphoma patients undergoing autologous hematopoietic cell transplantation (HCT): a report from the Center For International Blood & Marrow Transplant Research (CIBMTR).
To compare the clinical outcomes of older (age > or =55 years) non-Hodgkin lymphoma (NHL) patients with younger NHL patients (<55 years) receiving autologous hematopoietic cell transplantation (HCT) while adjusting for patient-, disease-, and treatment-related variables, we compared autologous HCT outcomes in 805 NHL patients aged > or =55 years to 1949 NHL patients <55 years during the years 1990-2000 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). In multivariate analysis, older patients with aggressive histologies were 1.86 times (95% confidence interval [CI] 1.43-2.43, P < .001) more likely than younger patients to experience treatment-related mortality (TRM). Relative death risks were 1.33 times (CI 1.04-1.71, P = .024) and 1.50 times (CI 1.33-16.9, P < .001) higher in older compared to younger patients with follicular grade I/II and aggressive histologies, respectively. Autologous HCT in older NHL patients is feasible, but most disease-related outcomes are statistically inferior to younger patients. Studies addressing supportive care particular to older patients, who are most likely to benefit from this approach, are recommended.
Lazarus
Hillard M
HM
Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio, USA. hillard.lazarus@case.edu
Carreras
Jeanette
J
Boudreau
Christian
C
Loberiza
Fausto R
FR
Armitage
James O
JO
Bolwell
Brian J
BJ
Freytes
César O
CO
Gale
Robert Peter
RP
Gibson
John
J
Hale
Gregory A
GA
Inwards
David J
DJ
LeMaistre
Charles F
CF
Maharaj
Dipnarine
D
Marks
David I
DI
Miller
Alan M
AM
Pavlovsky
Santiago
S
Schouten
Harry C
HC
van Besien
Koen
K
Vose
Julie M
JM
Bitran
Jacob D
JD
Khouri
Issa F
IF
McCarthy
Philip L
PL
Yu
Hongmei
H
Rowlings
Philip
P
Serna
Derek S
DS
Horowitz
Mary M
MM
Rizzo
J Douglas
JD
D000328:Adult; D000367:Age Factors; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008228:Lymphoma, Non-Hodgkin / Q000401:mortality* / Q000473:pathology* / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D015996:Survival Rate; D014182:Transplantation, Autologous