title: Comorbidities, not age, are predictive of survival after autologous hematopoietic cell transplantation for relapsed/refractory Hodgkin's lymphoma in patients older than 50 years.
abstract: Autologous hematopoietic cell transplantation (AHCT) is the standard of care for young patients with relapsed/refractory (R/R) Hodgkin's lymphoma (HL). However, there is limited experience of its efficacy and feasibility in older patients. The characteristics and outcomes of 121 patients aged ≥50 years (42 of them are ≥60 years old) with R/R HL who underwent AHCT were reviewed. After a median follow-up of 3.1 years, overall survival (OS) and progression-free survival (PFS) at 5 years were 64 and 55 %, respectively, with no differences between 50-59-year-old and ≥60-year-old patients. Hematological and extra-hematological toxicities after AHCT were comparable between the two groups of age. In univariate analysis, poorer OS and PFS were associated with disease status other than complete remission, hematopoietic cell transplantation comorbidity index (HCT-CI) scores >1, and Charlson Comorbidity Index (CCI) scores >1. HCT-CI scores >1 were also associated with a higher risk of grade 3-4 extrahematologic toxicity. In multivariate analysis, HCT-CI and CCI remained significantly associated with OS and PFS after adjustment for disease status. Our data show that AHCT can be performed in selected patients with R/R HL ≥50 years with acceptable outcome and toxicity. Comorbidities appear to impact AHCT outcome more than age.
authors.affiliation: Hematology Department, Institute of Hematology and Oncology, Hospital Clínic, Villarroel 170, Barcelona, 08036, Spain. cmarti@clinic.ub.es.
authors.forename: C
authors.initials: C
authors.lastname: Martínez
authors.affiliation: Hematology Department, Institute of Hematology and Oncology, Hospital Clínic, Villarroel 170, Barcelona, 08036, Spain.
authors.forename: A S
authors.initials: AS
authors.lastname: Jorge
authors.affiliation: Hemotherapy and Hemostasis Department, Hospital Clínic, Barcelona, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Pereira
authors.affiliation: Hematology Department, Hospital Germans Trias I Pujol, Badalona, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Moreno
authors.affiliation: Hematology Department, Hospital Universitario Marqués de Valdecilla, Santander, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Núñez
authors.affiliation: Hematology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gayoso
authors.affiliation: Hematology Department, Hospital 12 de Octubre, Madrid, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Gonzalez-Medina
authors.affiliation: Hematology Department, Hospital Ramón y Cajal, Madrid, Spain.
authors.forename: N
authors.initials: N
authors.lastname: Revilla
authors.affiliation: Hematology Department, Hospital Son Espases, Mallorca, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Sampol
authors.affiliation: Hematology Department, Hospital Duran I Reynals, Barcelona, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Domingo-Domenech
authors.affiliation: Hematology Department, Hospital Virgen del Rocío, Sevilla, Spain.
authors.forename: F
authors.initials: F
authors.lastname: de la Cruz
authors.affiliation: Hematology Department, Hospital Puerta de Hierro, Madrid, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Morales
authors.affiliation: Hematology Department, Hospital Universitario de Canarias, San Cristóbal de La Laguna, Tenerife, Spain.
authors.forename: M J
authors.initials: MJ
authors.lastname: Rodriguez-Salazar
authors.affiliation: Hematology Department, Hospital Morales Meseguer, Murcia, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Valiente
authors.affiliation: Hematology Department, Hospital de la Arrixaca, Murcia, Spain.
authors.forename: E
authors.initials: E
authors.lastname: Pérez-Ceballos
authors.affiliation: Hematology Department, Hospital Sanchinarro, Madrid, Spain.
authors.forename: J Pérez
authors.initials: JP
authors.lastname: de Oteyza
authors.affiliation: Hematology Department, Hospital Clínico, Salamanca, Spain.
authors.forename: R
authors.initials: R
authors.lastname: García-Sanz
mesh_terms: D000367:Age Factors; D000368:Aged; D015897:Comorbidity; D018572:Disease-Free Survival; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000401:mortality / Q000639:trends*; D006689:Hodgkin Disease / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D014182:Transplantation, Autologous / Q000401:mortality / Q000639:trends; D016896:Treatment Outcome
keywords: Autologous hematopoietic cell transplantation; Comorbidity; Elderly patients; Hodgkin’s lymphoma