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Blood Cancer J. 2019 Dec 3;9(12):97. doi: 10.1038/s41408-019-0261-1.

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

Author information

1
BMT & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI, USA.
2
CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
3
Division of Biostatistics, Institute for Health and Equity, Medical College of Wisconsin, Milwaukee, WI, USA.
4
Hematology Department, Institut Català d'Oncologia - Hospitalet, Barcelona, Spain.
5
Division of Hematology-Oncology, Blood and Marrow Transplantation Program, Mayo Clinic, Jacksonville, FL, USA.
6
Ohio Stat Medical Center, James Cancer Center, Columbus, OH, USA.
7
Division of Hematological Malignancy and Cellular Therapeutics, University of Kansas Health System, Kansas City, KS, USA.
8
Hematolgic Malignancies & Bone Marrow Transplant, Department of Medical Oncology, New York Presbyterian Hospital/Weill Cornell Medical Center, New York, NY, USA.
9
Division of Hematology, Mayo Clinic, Rochester, MN, USA.
10
Northwestern University, Chicago, IL, USA.
11
H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL, USA.
12
University of Miami, Miami, FL, USA.
13
Georgetown University Hospital, Washington, DC, USA.
14
Rush University Medical Center, Chicago, IL, USA.
15
Division of Hematology, Ohio State University, Columbus, OH, USA.
16
The Blood and Marrow Transplant Group of Georgia, Northside Hospital, Atlanta, GA, USA.
17
Division of Hematology and Oncology, Mount Sinai Hospital, New York, NY, USA.
18
Division of Hematology and Oncology, Washington University School of Medicine, St. Louis, MO, USA.
19
Division of Hematology/Oncology, Department of Medicine, University of North Carolina, Chapel Hill, NC, USA.
20
Division of Hematology and Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA.
21
Section of Hematology/Oncology, The University of Chicago, Chicago, IL, USA.
22
BMT & Cellular Therapy Program, Medical College of Wisconsin, Milwaukee, WI, USA. mhamadani@mcw.edu.
23
CIBMTR (Center for International Blood and Marrow Transplant Research), Department of Medicine, Medical College of Wisconsin, Milwaukee, WI, USA. mhamadani@mcw.edu.

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.

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