Comorbidities, not age, are predictive of survival after autologous hematopoietic cell transplantation for relapsed/refractory Hodgkin's lymphoma in patients older than 50 years
Por:
Martinez, C, Jorge, AS, Pereira, A, Moreno, M, Nunez, J, Gayoso, J, Gonzalez-Medina, J, Revilla, N, Sampol, A, Domingo-Domenech, E, de la Cruz, F, Morales, A, Rodriguez-Salazar, M, Valiente, S, Perez-Ceballos, E, de Oteyza, JP and Garcia-Sanz, R
Publicada:
1 ene 2017
Resumen:
Autologous hematopoietic cell transplantation (AHCT) is the standard of care for young patients with relapsed/refractory (R/R) Hodgkin's lymphoma (HL). However, there is limited experience of its efficacy and feasibility in older patients. The characteristics and outcomes of 121 patients aged 50 years (42 of them are 60 years old) with R/R HL who underwent AHCT were reviewed. After a median follow-up of 3.1 years, overall survival (OS) and progression-free survival (PFS) at 5 years were 64 and 55 %, respectively, with no differences between 50-59-year-old and 60-year-old patients. Hematological and extra-hematological toxicities after AHCT were comparable between the two groups of age. In univariate analysis, poorer OS and PFS were associated with disease status other than complete remission, hematopoietic cell transplantation comorbidity index (HCT-CI) scores > 1, and Charlson Comorbidity Index (CCI) scores > 1. HCT-CI scores > 1 were also associated with a higher risk of grade 3-4 extrahematologic toxicity. In multivariate analysis, HCT-CI and CCI remained significantly associated with OS and PFS after adjustment for disease status. Our data show that AHCT can be performed in selected patients with R/R HL 50 years with acceptable outcome and toxicity. Comorbidities appear to impact AHCT outcome more than age.
Filiaciones:
Martinez, C:
Hosp Clin Barcelona, Dept Hematol, Inst Hematol & Oncol, Villarroel 170, E-08036 Barcelona, Spain
Jorge, AS:
Hosp Clin Barcelona, Dept Hematol, Inst Hematol & Oncol, Villarroel 170, E-08036 Barcelona, Spain
Pereira, A:
Hosp Clin Barcelona, Hemotherapy & Hemostasis Dept, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, Dept Hematol, Badalona, Spain
Nunez, J:
Hosp Univ Marques de Valdecilla, Dept Hematol, Santander, Spain
Gayoso, J:
Hosp Gen Univ Gregorio Maranon, Dept Hematol, Madrid, Spain
Gonzalez-Medina, J:
Hosp 12 Octubre, Dept Hematol, Madrid, Spain
Revilla, N:
Hosp Ramon & Cajal, Dept Hematol, Madrid, Spain
Sampol, A:
Hosp Son Espases, Dept Hematol, Mallorca, Spain
Domingo-Domenech, E:
Hosp Duran I Reynals, Dept Hematol, Barcelona, Spain
de la Cruz, F:
Hosp Virgen del Rocio, Dept Hematol, Seville, Spain
Morales, A:
Hosp Puerta de Hierro, Dept Hematol, Madrid, Spain
Rodriguez-Salazar, M:
Hosp Univ Canarias, Dept Hematol, Tenerife, Spain
Valiente, S:
Hosp Morales Meseguer, Dept Hematol, Murcia, Spain
Perez-Ceballos, E:
Hosp Arrixaca, Dept Hematol, Murcia, Spain
de Oteyza, JP:
Hosp Sanchinarro, Dept Hematol, Madrid, Spain
Garcia-Sanz, R:
Hosp Clin Salamanca, Dept Hematol, Salamanca, Spain
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