Allogeneic transplantation in elderly patients ≥65 years with non-Hodgkin lymphoma: a time-trend analysis.

Abstract

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.

• Authors: Nirav N Shah, Kwang Woo Ahn, Carlos Litovich, Anna Sureda, Mohamed A Kharfan-Dabaja, Farrukh T Awan, Siddhartha Ganguly, Usama Gergis, David Inwards, Reem Karmali, Alexsandr Lazaryan, Lazaros Lekakis, Pashna Munshi, Sunita Nathan, Ayman A Saad, Melhem Solh, Amir Steinberg, Ravi Vij, William A Wood, Timothy S Fenske, Sonali Smith, Mehdi Hamadani
• Journal: Blood cancer journal (Blood Cancer J) Vol. 9 Issue 12 Pg. 97 (12 03 2019) ISSN: 2044-5385 [Electronic] United States
• PMID: 31796726 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, Non-P.H.S., Research Support, U.S. Gov't, P.H.S.)

Topics

• Aged
• Aged, 80 and over
• Drug Resistance, Neoplasm
• Female
• Graft vs Host Disease (etiology)
• Hematopoietic Stem Cell Transplantation (adverse effects, methods)
• Humans
• Lymphoma, Non-Hodgkin (diagnosis, mortality, therapy)
• Male
• Neoplasm Grading
• Neoplasm Staging
• Prognosis
• Recurrence
• Transplantation, Homologous
• Treatment Outcome