title: High-dose chemotherapy with carmustine, etoposide, cytarabine and melphalan followed by autologous stem cell transplant is an effective treatment for elderly patients with poor-prognosis lymphoma.
abstract: Autologous stem cell transplant (ASCT) after high-dose chemotherapy (HDT) increases overall survival when used in relapsed non-Hodgkin lymphoma (NHL) in patients under 65 years old. Limited experience is available for older patients. We present a retrospective analysis of 73 consecutive patients aged over 65 years treated for aggressive or relapsed lymphoma by HDT with carmustine, etoposide, cytarabine and melphalan (BEAM) at full dosage followed by ASCT. Patient data were obtained from medical charts from two institutions. Median age was 67 years (65-74). Significant comorbidities were present in 24.7% of patients. The median number of days for grade 4 neutropenia was 9 (5-18). The early treatment-related mortality rate (<100 days) was 2.7%. The estimated 2-year progression-free survival and overall survival rates were 67.2% and 78.5%, respectively. In conclusion, the full-dose HDT-ASCT regimen is feasible, safe and efficient in selected patients over 65 years old.
authors.affiliation: a Department of Oncology , Antoine-Lacassagne Center , Nice , France.
authors.forename: Nicolas
authors.initials: N
authors.lastname: Martin
authors.affiliation: a Department of Oncology , Antoine-Lacassagne Center , Nice , France.
authors.forename: Delphine
authors.initials: D
authors.lastname: Borchiellini
authors.affiliation: b Department of Hematology , Paoli-Calmettes Institute , Marseille , France.
authors.forename: Diane
authors.initials: D
authors.lastname: Coso
authors.affiliation: a Department of Oncology , Antoine-Lacassagne Center , Nice , France.
authors.forename: Lauris
authors.initials: L
authors.lastname: Gastaud
authors.affiliation: a Department of Oncology , Antoine-Lacassagne Center , Nice , France.
authors.forename: Annick
authors.initials: A
authors.lastname: Boscagli
authors.affiliation: c Department of Oncology , Cannes Hospital , France.
authors.forename: Laurence
authors.initials: L
authors.lastname: Saudes
authors.affiliation: d Department of Oncology , Antibes-Juan-les-Pins Hospital , France.
authors.forename: Daniel
authors.initials: D
authors.lastname: Re
authors.affiliation: e Department of Oncology , Frejus-Saint Raphael Hospital , France.
authors.forename: Jean
authors.initials: J
authors.lastname: Gutnecht
authors.affiliation: f Department of Oncology , Princesse Grace Hospital Center , Monaco.
authors.forename: Georges
authors.initials: G
authors.lastname: Garnier
authors.affiliation: g Department of Oncology , Oxford Clinic , Cannes , France.
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Petit
authors.affiliation: h Department of Oncology , St-Jean Polyclinic , Cagnes-sur-Mer , France.
authors.forename: Jèrôme
authors.initials: J
authors.lastname: Barriere
authors.affiliation: i Azurean Center of Oncology , Mougins , France.
authors.forename: Hervé
authors.initials: H
authors.lastname: Naman
authors.affiliation: j La Dracenie Hospital Center , Draguignan , France.
authors.forename: Benoit
authors.initials: B
authors.lastname: Rossignol
authors.affiliation: a Department of Oncology , Antoine-Lacassagne Center , Nice , France.
authors.forename: Antoine
authors.initials: A
authors.lastname: Thyss
authors.affiliation: a Department of Oncology , Antoine-Lacassagne Center , Nice , France.
authors.forename: Frederic
authors.initials: F
authors.lastname: Peyrade
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D002330:Carmustine / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000009:adverse effects / Q000627:therapeutic use; D018450:Disease Progression; D005047:Etoposide / Q000009:adverse effects / Q000627:therapeutic use; D005260:Female; D005602:France; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D008223:Lymphoma / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D008297:Male; D008558:Melphalan / Q000009:adverse effects / Q000627:therapeutic use; D011379:Prognosis; D012008:Recurrence; D012189:Retrospective Studies; D016019:Survival Analysis; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D003561:Cytarabine; D005047:Etoposide; D008558:Melphalan; D002330:Carmustine
keywords: Autologous stem cell transplant; BEAM; elderly; lymphoma