High-dose chemotherapy and auto-SCT in elderly patients with Hodgkin's lymphoma

Abstract

Our purpose was to assess efficacy and toxicity of highdose chemotherapy (HDCT) and ASCT in patients with relapsed and refractory Hodgkin's lymphoma (HL) aged 60 years and older and compare the results with a group of younger HL patients treated in a similar manner. We identified 15 consecutive patients, with HL aged 60 years and older who underwent HDCT (etoposide 60 mg/kg þ melphalan 160 mg/m 2 ) and ASCT at our institution from May 2001 to March 2008. The results were compared with a cohort of 157 younger HL patients treated in a similar manner from January 1999 to December 2006. After a median follow-up of 2.5 years, PFS at 3 years after ASCT was 73% (95% confidence interval (CI) 37-90) for the older group and 56% (95% CI 46-64) for the younger group (P ¼ 0.45); OS after ASCT was 88% (95% CI 39-98) for the older group and 84% (95% CI 75-90) for the younger group (P ¼ 0.80). No transplantrelated deaths were seen. Our study suggests that ASCT is feasible for selected elderly patients with HL, giving similar results to younger patients in terms of survival and toxicity.

Autologous stem cell transplantation for patients aged 60 years or older with refractory or relapsed classical Hodgkin’s lymphoma: a retrospective analysis from the French Society of Bone Marrow Transplantation and Cell Therapies (SFGM-TC)

“…In our study, the 6-year OS was 64%. This value is lower than that reported in the Puig et al (88%) 8 series, but in this series, only 15 elderly patients were analyzed with a median follow-up of 2.5 years. However, similar to our study, only transplanted patients were analyzed.…”

“…20 In our series, hematopoietic engraftment and extra-hematopoietic toxicities (mainly mucositis) compared favorably to other series. 8 A high proportion of patients received G-CSF support after transplant, which could explain the low level of infection but no significant correlation could be observed between the use of G-CSF and neutrophil recovery, toxicity and length of hospitalization. Early mortality ( o3 months) was related to transplant procedures in 3% of patients (for three patients the cause of death was not specified).…”

“…1 Their survival rates are inferior to those of younger patients (5-year survival rates of 50 versus 80%, respectively) for several reasons, including disease features, lower delivery of standard chemotherapy and excessive toxicity. [2][3][4][5][6][7][8][9][10][11][12][13][14] No standard of care is available for first 14 or additional lines of chemotherapy for this age group. ASCT is a usual treatment in R/R cHL young patients.…”

“…However, only a few studies have examined ASCT in elderly patients (⩾60 years) with R/R HL. 8 To assess this treatment option, we retrospectively analyzed the efficacy and toxicity of high-dose chemotherapy followed by ASCT in 91 patients with R/R cHL recorded in the SFGM-TC database and correlated survival with well-known prognostic factors.…”

Hodgkin’s Lymphoma - evaluation of patients submitted to Autologous transplantation of hematopoietic cells in the Hematology Service of the Hospital Walter Cantídio – Fortaleza, Brazil.

“…7,8,9,10,11,12 The present analysis of transplanted patients at UTMO/HUWC/UFC shows a young population (mean age of 28 years), with a predominance of localized disease (I+II), mostly B, initially treated with standard regimen (ABVD) and who did not respond or had recurrence, becoming candidates for a new treatment regimen and the possibility of BMT indication. However, 50.0% of them came to transplantation in partial remission of the lymphoma, showing much lower results when considering the patient coming to the BMT in complete remission (64.7% vs. 35.3%).…”