Influence of age and histology on outcome in adult non-Hodgkin lymphoma patients undergoing autologous hematopoietic cell transplantation (HCT): a report from the Center For International Blood & Marrow Transplant Research (CIBMTR)

年龄和组织学对接受自体造血细胞移植 (HCT) 的成年非霍奇金淋巴瘤患者预后的影响:国际血液和骨髓移植研究中心 (CIBMTR) 的报告

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作者:Hillard M Lazarus, Jeanette Carreras, Christian Boudreau, Fausto R Loberiza Jr, James O Armitage, Brian J Bolwell, César O Freytes, Robert Peter Gale, John Gibson, Gregory A Hale, David J Inwards, Charles F LeMaistre, Dipnarine Maharaj, David I Marks, Alan M Miller, Santiago Pavlovsky, Harry C Schou

Abstract

To compare the clinical outcomes of older (age > or =55 years) non-Hodgkin lymphoma (NHL) patients with younger NHL patients (<55 years) receiving autologous hematopoietic cell transplantation (HCT) while adjusting for patient-, disease-, and treatment-related variables, we compared autologous HCT outcomes in 805 NHL patients aged > or =55 years to 1949 NHL patients <55 years during the years 1990-2000 using data reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). In multivariate analysis, older patients with aggressive histologies were 1.86 times (95% confidence interval [CI] 1.43-2.43, P < .001) more likely than younger patients to experience treatment-related mortality (TRM). Relative death risks were 1.33 times (CI 1.04-1.71, P = .024) and 1.50 times (CI 1.33-16.9, P < .001) higher in older compared to younger patients with follicular grade I/II and aggressive histologies, respectively. Autologous HCT in older NHL patients is feasible, but most disease-related outcomes are statistically inferior to younger patients. Studies addressing supportive care particular to older patients, who are most likely to benefit from this approach, are recommended.

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