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

Year: 2019

Type: article

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.

Source: Blood Cancer Journal

DOI: 10.1038/s41408-019-0261-1

Institutions: Medical College of Wisconsin, Institut Català d'Oncologia, Mayo Clinic, Mayo Clinic in Florida, The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, The University of Kansas Health System, NewYork–Presbyterian Hospital, Weill Cornell Medical Center, Northwestern University, Moffitt Cancer Center, University of Miami, Georgetown University, Rush University Medical Center, The Ohio State University, Northside Hospital, Mount Sinai Hospital, Washington University in St. Louis, University of North Carolina at Chapel Hill, University of Chicago

Language: English

Topic: Hematopoietic Stem Cell Transplantation

Subfield: Hematology

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $4,380

Funders: National Marrow Donor Program, U.S. Department of Defense, U.S. Department of Health and Human Services, Be The Match Foundation, Amgen, Bristol-Myers Squibb, Pfizer, Astellas Pharma US, GlaxoSmithKline, Sanofi, Gilead Sciences, St. Baldrick's Foundation, Patient-Centered Outcomes Research Institute, Spectrum Pharmaceuticals, Celgene, HistoGenetics, University of Wisconsin-Madison, Karyopharm Therapeutics, University of Minnesota, University of Pittsburgh, Novartis Pharmaceuticals Corporation, CSL Behring, Medical College of Wisconsin, Regeneron Pharmaceuticals, Actinium Pharmaceuticals, Jazz Pharmaceuticals, Atara Biotherapeutics, bluebird bio, Adaptive Biotechnologies, Chimerix, Janssen Scientific Affairs, Incyte, Omeros Corporation, Daiichi-Sankyo, Astellas Pharma, Swedish Orphan Biovitrum, Medac, Health Resources and Services Administration, U.S. Public Health Service, University of Texas MD Anderson Cancer Center, U.S. Navy, Takeda Oncology, Sanofi Genzyme, Mundipharma EDO, National Heart, Lung, and Blood Institute, Office of Naval Research, National Cancer Institute, National Institute of Allergy and Infectious Diseases, Janssen Biotech, Janssen Pharmaceuticals, Daiichi Sankyo Europe

OpenAlex ID: W2994015348