TY - JOUR
T1 - High-Dose Chemotherapy with Autologous Stem Cell Transplantation for Elderly Patients with Relapsed/Refractory Diffuse Large B Cell Lymphoma
T2 - A Nationwide Retrospective Study
AU - Chihara, Dai
AU - Izutsu, Koji
AU - Kondo, Eisei
AU - Sakai, Rika
AU - Mizuta, Shuichi
AU - Yokoyama, Kenji
AU - Kaneko, Hiroto
AU - Kato, Koji
AU - Hasegawa, Yuichi
AU - Chou, Takaaki
AU - Sugahara, Hiroyuki
AU - Henzan, Hideho
AU - Sakamaki, Hisashi
AU - Suzuki, Ritsuro
AU - Suzumiya, Junji
PY - 2014/5
Y1 - 2014/5
N2 - The number of elderly patients with diffuse large Bcell lymphoma (DLBCL) continues to increase but the data regarding autologous stem cell transplantation (ASCT) for elderly patients are limited. We analyzed 484 patients, ages 60years or over, diagnosed with relapsed/refractory DLBCL who received ASCT from 1993 to 2010 in the Japan Society for Hematopoietic Cell Transplantation database. Median age was 64years (range, 60 to 78). To evaluate the impact of age at ASCT, patients were classified into 3 groups: those between the ages of 60 to 64, 65 to 69, and 70years or over. Overall nonrelapse mortality (NRM) at day 100, 1year, and 2years was 4.1%, 5.9% and 7.7%, respectively. NRM did not significantly differ among age groups (P=.60). Two-year progression-free survival (PFS) and overall survival (OS) were 48% and 58%, respectively. PFS and OS were significantly longer in patients 60 to 64years old; however, the survival rate was acceptable even in those 70 or over, with a 2-year OS of 46%. ASCT is feasible in selected elderly patients and age alone should not be a contraindication for ASCT. Eligibility should be individualized and identification of a subset of elderly patients at high risk of treatment-related morbidity or mortality warrants investigation.
AB - The number of elderly patients with diffuse large Bcell lymphoma (DLBCL) continues to increase but the data regarding autologous stem cell transplantation (ASCT) for elderly patients are limited. We analyzed 484 patients, ages 60years or over, diagnosed with relapsed/refractory DLBCL who received ASCT from 1993 to 2010 in the Japan Society for Hematopoietic Cell Transplantation database. Median age was 64years (range, 60 to 78). To evaluate the impact of age at ASCT, patients were classified into 3 groups: those between the ages of 60 to 64, 65 to 69, and 70years or over. Overall nonrelapse mortality (NRM) at day 100, 1year, and 2years was 4.1%, 5.9% and 7.7%, respectively. NRM did not significantly differ among age groups (P=.60). Two-year progression-free survival (PFS) and overall survival (OS) were 48% and 58%, respectively. PFS and OS were significantly longer in patients 60 to 64years old; however, the survival rate was acceptable even in those 70 or over, with a 2-year OS of 46%. ASCT is feasible in selected elderly patients and age alone should not be a contraindication for ASCT. Eligibility should be individualized and identification of a subset of elderly patients at high risk of treatment-related morbidity or mortality warrants investigation.
KW - Autologous stem cell transplantation
KW - Diffuse large Bcell lymphoma
KW - Elderly patients
KW - Relapse/refractory
UR - http://www.scopus.com/inward/record.url?scp=84897960368&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84897960368&partnerID=8YFLogxK
U2 - 10.1016/j.bbmt.2014.01.025
DO - 10.1016/j.bbmt.2014.01.025
M3 - Article
C2 - 24492141
AN - SCOPUS:84897960368
SN - 1083-8791
VL - 20
SP - 684
EP - 689
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 5
ER -