Abstract
Although high-dose therapy with autologous hematopoietic stem cell transplantation (ASCT) is a widely used method of dose intensification in patients with hematological malignancies, patients aged over 60 are generally excluded. We evaluated high-dose therapy and ASCT in 29 cases involving 27 such patients (median age 63 years; range 61–68) with different malignancies. Patients were eligible if they had a good performance status, normal cardiac, respiratory, and hepatic function and a serum creatinine concentration of less than 2 mg/dl (<5 mg/dl in myeloma patients). Engraftment was assessable in 27 procedures. The median time to attain 0.5 and 1 × 109 PMN/l was 13 days (range 9–30) and 14 days (range 10–66), respectively. The median time taken to reach a platelet count greater than 50 × 109/l was 14 days (range 8–223). Five patients (17%) died in the first 100 days after transplant, in two cases due to disease progression. The remaining three patients died as a consequence of transplant-related complications, with an overall transplant-related mortality of 10%. Five patients relapsed and died between 5 and 36 months after transplant. The remaining 17 patients are still alive without disease progression, with an actuarial overall survival of 47% at 42 months (95% CI 33–61). We consider that high-dose therapy with ASCT should be considered in those elderly patients with good performance status and without general organ impairment. Bone Marrow Transplantation (2001) 27, 21–25.
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de la Rubia, J., Saavedra, S., Sanz, G. et al. Transplant-related mortality in patients older than 60 years undergoing autologous hematopoietic stem cell transplantation. Bone Marrow Transplant 27, 21–25 (2001). https://doi.org/10.1038/sj.bmt.1702736
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DOI: https://doi.org/10.1038/sj.bmt.1702736
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