High-Dose Chemotherapy with Autologous Stem Cell Transplantation for Elderly Patients with Relapsed/Refractory Diffuse Large B Cell Lymphoma: A Nationwide Retrospective Study

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Abstract

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. © 2014 American Society for Blood and Marrow Transplantation.

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Chihara, D., Izutsu, K., Kondo, E., Sakai, R., Mizuta, S., Yokoyama, K., … Suzumiya, J. (2014). High-Dose Chemotherapy with Autologous Stem Cell Transplantation for Elderly Patients with Relapsed/Refractory Diffuse Large B Cell Lymphoma: A Nationwide Retrospective Study. Biology of Blood and Marrow Transplantation, 20(5), 684–689. https://doi.org/10.1016/j.bbmt.2014.01.025

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