Allogeneic transplantation in elderly patients ≥65 years with non-Hodgkin lymphoma: a time-trend analysis.
Nirav N ShahKwang Woo AhnCarlos LitovichAnna SuredaMohamed A Kharfan-DabajaFarrukh T AwanSiddhartha GangulyUsama GergisDavid InwardsReem KarmaliAlexsandr LazaryanLazaros LekakisPashna MunshiSunita NathanAyman A SaadMelhem SolhAmir SteinbergRavi VijWilliam A WoodTimothy S FenskeSonali SmithMehdi HamadaniPublished in: Blood cancer journal (2019)
Allogeneic hematopoietic cell transplantation (allo-HCT) is a curative therapy for relapsed/refractory and high-risk non-Hodgkin lymphoma (NHL). However, no large studies have evaluated allo-HCT utilization in elderly NHL patients (≥65 years). Using the CIBMTR registry, we report a time-trend analysis of 727 NHL patients (≥65 years) undergoing the first allo-HCT from 2000 to 2015 in the United States (US). Study cohorts were divided by time period: 2000-2005 (N = 76) vs. 2006-2010 (N = 238) vs. 2011-2015 (N = 413). Primary outcome was overall survival (OS). Secondary outcomes included progression-free survival (PFS), relapse/progression (R/P), and non-relapse mortality (NRM). Median age at transplant, use of reduced-intensity conditioning, and graft source remained stable, while use of unrelated donors increased in the most current era. The 1-year probabilities of NRM from 2000 to 2005 vs. 2006-2010 vs. 2011-2015 were 24% vs. 19% vs. 21%, respectively (p = 0.67). Four-year probability of R/P was similar among the three cohorts: 48% (2000-2005), 40% (2006-2010), and 40% (2011-2015) (p = 0.39). The 4-year probabilities of PFS and OS (2000-2005 vs. 2006-2010 vs. 2011-2015) showed significantly improved outcomes in more recent time periods: 17% vs. 31% vs. 30% (p = 0.02) and 21% vs. 42% vs. 44% (p < 0.001), respectively. Utilization of allo-HCT increased in elderly NHL patients in the US since 2000 with improving survival outcomes.
Keyphrases
- end stage renal disease
- free survival
- ejection fraction
- newly diagnosed
- chronic kidney disease
- peritoneal dialysis
- prognostic factors
- type diabetes
- bone marrow
- metabolic syndrome
- cardiovascular disease
- coronary artery disease
- cell proliferation
- adipose tissue
- rectal cancer
- insulin resistance
- mesenchymal stem cells
- high intensity
- cell therapy
- community dwelling
- cell cycle arrest