Predicting the effects of stem cell transplant in older patients with non-Hodgkin lymphoma.

This study investigated the effects of stem cell transplant for non-Hodgkin lymphoma (NHL) in older patients. The main finding was that patients who responded to chemotherapy had better outcomes after stem cell transplant.

Stem cell transplant is often used to treat NHL. This involves the transfer of healthy cells to a patient. Patients often receive combinations of chemotherapy before stem cell transplant. In older patients with NHL, stem cell transplant may result in the development of another disease. It may also lead to death.

Predicting the likelihood of developing another disease may determine which patients are best suited to getting a transplant. This may also reduce the likelihood of a patient dying following a transplant. It is important to investigate what influences the effects an older patient will experience after a stem cell transplant. This may help doctors to pick patients for whom stem cell transplant may be most successful.

Ninety patients over 60 with NHL were included in this study. Forty-four percent of patients were treated with BEAM [carmustine (BCNU), etoposide (VePesid), aracytine (Cytarabine) and melphalan (Alkeran)] chemotherapy before transplant. Fifty percent of patients were treated with BEAC [carmustine, etoposide, aracytine, and cyclophosphamide (Cytoxan)] chemotherapy before transplant. The effects of stem cell transplant were investigated.

34% of patients were at a low risk of developing a transplant-associated disease. 40% of patients were at a medium risk of developing another disease. 26% of patients were highly likely to develop a disease after transplant. The average time before cancer worsening was 56 months after stem cell transplant.

Five years after transplant, 47% of patients, had not experienced cancer worsening. The estimated 5-year overall survival was 60%. Heart attack after leaving the hospital was the only severe side effect experienced. At both 1 year and 5 years after stem cell transplant, only 1% of patients had died without cancer returning or getting worse.

The main finding was that response to chemotherapy was related to more successful stem cell transplant for NHL in patients over 60.

This study included patients who were all treated in the same center. Therefore, the results may not be applicable to patients treated elsewhere.