Autologous stem cell transplantation in elderly (>60 years) patients with non-Hodgkin's lymphoma:: a nation-wide analysis

Limited experience is available on the feasibility and efficacy of autologous stem cell transplantation (ASCT) in elderly patients with non-Hodgkin's lymphoma (NHL). In 1994-2004 altogether 88 NHL patients >60 years old received ASCT in six Finnish transplant centres. There were 57 male and 31 female patients witha median age of 63 years (range 60-70 years); 17 patients were >65 years. The histology included diffuse large B cell (n = 29), mantle cell (n = 27), follicular (n = 15), peripheral T cell (n = 12) and other (n = 5). Disease status at ASCT was I complete remission/partial remission (CR/PR) in 53 patients, II CR/PR in 30 patients and other in five patients. The conditioning regimens included BEAC (n = 49), BEAM (n = 34), TBI-CY (n = 4) and other (n = 1). Eighty-four patients received PB grafts. The medians to reach neutrophils >0.5 and platelets >20 were 10 and 14 days, respectively. The early treatment-related mortality (TRM) (<100 days) was 11%. Witha median follow-up of 21 months for all patients, 45 patients (51%) are alive. A relapse or progression after ASCT has been observed in 32 patients (36%). ASCT is feasible in selected elderly patients with NHL, but the early TRM seems to be higher than in younger patients.