title: 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).
abstract: 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.
authors.affiliation: Department of Medicine, University Hospitals Case Medical Center, Cleveland, Ohio, USA. hillard.lazarus@case.edu
authors.forename: Hillard M
authors.initials: HM
authors.lastname: Lazarus
authors.forename: Jeanette
authors.initials: J
authors.lastname: Carreras
authors.forename: Christian
authors.initials: C
authors.lastname: Boudreau
authors.forename: Fausto R
authors.initials: FR
authors.lastname: Loberiza
authors.forename: James O
authors.initials: JO
authors.lastname: Armitage
authors.forename: Brian J
authors.initials: BJ
authors.lastname: Bolwell
authors.forename: César O
authors.initials: CO
authors.lastname: Freytes
authors.forename: Robert Peter
authors.initials: RP
authors.lastname: Gale
authors.forename: John
authors.initials: J
authors.lastname: Gibson
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Hale
authors.forename: David J
authors.initials: DJ
authors.lastname: Inwards
authors.forename: Charles F
authors.initials: CF
authors.lastname: LeMaistre
authors.forename: Dipnarine
authors.initials: D
authors.lastname: Maharaj
authors.forename: David I
authors.initials: DI
authors.lastname: Marks
authors.forename: Alan M
authors.initials: AM
authors.lastname: Miller
authors.forename: Santiago
authors.initials: S
authors.lastname: Pavlovsky
authors.forename: Harry C
authors.initials: HC
authors.lastname: Schouten
authors.forename: Koen
authors.initials: K
authors.lastname: van Besien
authors.forename: Julie M
authors.initials: JM
authors.lastname: Vose
authors.forename: Jacob D
authors.initials: JD
authors.lastname: Bitran
authors.forename: Issa F
authors.initials: IF
authors.lastname: Khouri
authors.forename: Philip L
authors.initials: PL
authors.lastname: McCarthy
authors.forename: Hongmei
authors.initials: H
authors.lastname: Yu
authors.forename: Philip
authors.initials: P
authors.lastname: Rowlings
authors.forename: Derek S
authors.initials: DS
authors.lastname: Serna
authors.forename: Mary M
authors.initials: MM
authors.lastname: Horowitz
authors.forename: J Douglas
authors.initials: JD
authors.lastname: Rizzo
mesh_terms: 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