In a nutshell
This study evaluated the effectiveness of allogeneic stem cell transplants (allo-SCT) in elderly patients with non-Hodgkin’s lymphoma (NHL). This study found that allo-SCT has improved survival outcomes for these patients.
Some background
Allogeneic stem cell transplantation (allo-SCT) can be highly effective for patients with lymphoma. However, not all patients are good candidates for this treatment. The transplant requires high-dose chemotherapy be given first, to get rid of any remaining cancer cells. This treatment is called a conditioning regimen.
However, elderly patients may not be able to tolerate high-dose conditioning. Less intensive conditioning regimens can help elderly patients undergo allo-SCT. Previous studies have shown that elderly patients with NHL can have a successful transplant. The outcomes of these patients after SCT remain under investigation.
Methods & findings
This study looked at the records of 727 patients aged 65 or older who underwent allo-SCT. Patients were divided into three groups based on the year of transplant. 76 patients had the transplant between 2000 – 2005 (Group A). 238 patients had the transplant between 2006 – 2010 (Group B). 413 patients had the transplant between 2011 – 2015 (Group C). Patients were followed for an average of 36 months to 128 months.
On average, significantly more patients in Group C (44%) were still alive 4 years later compared to Group A (21%) and Group B (42%). Compared to Group A, patients in Group C had a significant 33% decrease in mortality risk.
Overall, 17% (Group A), 31% (Group B), and 30% (Group C) of patients were still alive 4 years later without tumor growth or spread. Among patients with NHL that did not respond to chemotherapy, more patients in Group C (48%) were still alive 4 years later compared to Groups A and B (29% and 31%).
At follow-up, 43% (Group A), 33% (Group B), and 34% (Group C) of patients had relapsed (cancer recurrence). Infections and graft-versus-host disease were also reported. Graft-versus-host disease occurs when the donor’s immune cells attack the patient’s healthy cells. It is a common complication of SCT.
The bottom line
This study found that allo-SCT has improved survival outcomes for elderly patients with NHL. The authors suggest that older adults with NHL should not be denied access to allo-SCT based on age alone.
The fine print
This study looked back in time to analyze data, which may bias these results. More studies are needed to confirm these results.
Published By :
Blood cancer journal
Date :
Dec 03, 2019
