Autologous Stem Cell Transplant is Feasible in Very Elderly Patients with Lymphoma and Limited Comorbidity

In patients with recurrent Hodgkin or non-Hodgkin\u27s lymphoma, autologous stem cell transplantation (ASCT) can offer potential for cure or long-term remission. Because of potential toxicity, elderly patients are usually not considered candidates, but data regarding tolerability and efficacy in this group are lacking. The transplant database at Weill Cornell Medical College was reviewed to identify patients with lymphoma undergoing ASCT at age 69 or greater. Clinical data and comorbidities were correlated with outcome. Twenty-one patients were identified. Sixteen of 19 evaluable patients (76%) achieved complete remission following ASCT, while 2 patients died before response assessment. Median progression-free survival following ASCT was 8 months and median overall survival was 18 months. Age was not predictive of overall survival, but patients 75 and older had inferior progression-free survival compared to younger patients. High-risk status by hematopoietic stem cell transplant comorbidity index (HCT-CI) was associated with short overall survival and high transplant-related mortality. ASCT is feasible and of potential benefit in selected elderly lymphoma patients. Consideration of comorbidities, rather than age alone, may allow selection of patients likely to tolerate and benefit from ASCT

Autologous Stem Cell Transplant is Feasible in Very Elderly Patients with Lymphoma and Limited Comorbidity

In patients with recurrent Hodgkin or non-Hodgkin\u27s lymphoma, autologous stem cell transplantation (ASCT) can offer potential for cure or long-term remission. Because of potential toxicity, elderly patients are usually not considered candidates, but data regarding tolerability and efficacy in this group are lacking. The transplant database at Weill Cornell Medical College was reviewed to identify patients with lymphoma undergoing ASCT at age 69 or greater. Clinical data and comorbidities were correlated with outcome. Twenty-one patients were identified. Sixteen of 19 evaluable patients (76%) achieved complete remission following ASCT, while 2 patients died before response assessment. Median progression-free survival following ASCT was 8 months and median overall survival was 18 months. Age was not predictive of overall survival, but patients 75 and older had inferior progression-free survival compared to younger patients. High-risk status by hematopoietic stem cell transplant comorbidity index (HCT-CI) was associated with short overall survival and high transplant-related mortality. ASCT is feasible and of potential benefit in selected elderly lymphoma patients. Consideration of comorbidities, rather than age alone, may allow selection of patients likely to tolerate and benefit from ASCT

Additional file 1: Table S1. of Combinatorial epigenetic therapy in diffuse large B cell lymphoma pre-clinical models and patients

Toxicity. Highest grade of treatment-emergent adverse events encountered at the four different dose levels. (DLs). DL1: azacitidine (AZA) 55 mg/m2 days 1–5 and vorinostat (VST) 300 mg BID days 1–7. DL2: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–7. DL3: AZA 55 mg/m2 days 1–5 and VST 300 mg BID days 1–14. DL4: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–14. (DOC 57.0 kb

Additional file 2: Table S2. of Combinatorial epigenetic therapy in diffuse large B cell lymphoma pre-clinical models and patients

Treatment response at the four different dose levels (DLs). DL1: Azacitidine (AZA) 55 mg/m2 days 1–5 and vorinostat (VST) 300 mg BID days 1–7. DL2: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–7. DL3: AZA 55 mg/m2 days 1–5 and VST 300 mg BID days 1–14. DL4: AZA 75 mg/m2 days 1–5 and VST 200 mg BID days 1–14. (DOC 39 kb