Journal
HAEMATOLOGICA-THE HEMATOLOGY JOURNAL
Volume 93, Issue 12, Pages 1837-1842Publisher
FERRATA STORTI FOUNDATION
DOI: 10.3324/haematol.13273
Keywords
autologous stem cell transplantation; diffuse large B-cell lymphoma; elderly patients; non-relapse mortality; outcome
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Background There is currently limited experience on the feasibility and efficacy of autologous stem cell transplantation in elderly patients with diffuse large B-cell lymphoma. Design and Methods We analyzed the outcome of 2612 patients with diffuse large B-cell lymphoma treated with autologous stem cell transplantation between 2000 and 2005 and reported to the European Blood and Marrow Transplantation registry. Four hundred and sixty-three patients (18%) were >= 60 years old at the time of the transplant (median, 63 years). When compared to 2149 patients <60 years old at the time of transplantation, the elderly patients had more frequently received at least two treatment lines (76% vs. 57%, p<0.001), were less commonly in first complete remission at the time of transplantation (23% vs. 30%, p=0.005) and received their transplants later after diagnosis (median time 14 months vs. 7.5 months, p<0.001). Results Non-relapse mortality was higher in elderly patients at 100 days (4.4% vs. 2.8%), at 1 year (8.7% vs. 4.7%) an at 3 years (10.8% vs. 6.5%) (p=0.002). With a median follow-up of 12 months for the surviving patients for the elderly group and 15 months for the younger group, the risk of relapse was 38% and 32%, respectively (p=0.006). The progression-free survival was 51% and 62%, respectively, at 3 years (p<0.001). The overall survival rate was 60% vs. 70%, respectively, at 3 years (p<0.001). Conclusions Autologous stem cell transplantation is feasible in selected elderly patients with diffuse large B-cell lymphoma, although non-relapse mortality is somewhat higher than in younger patients. Both progression-free and overall survival rates are promising taking into account the generally poorer outcome of elderly patients with diffuse large B-cell lymphoma.
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