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Autologous stem cell transplantation and stem cell mobilization kinetics in elderly patients with B cell non-Hodgkin lymphoma
Authors:Mehmet Hilmi Dogu  Seçkin Çagirgan  Serkan Ocakci  Ali Hakan Kaya  Kadir Ilkkilic  Neslihan Mandaci Sanli  Selda Kahraman  Rafet Eren  Emre Tekgunduz  Sibel Hacioglu  Leylagul Kaynar  Mehmet Ali Erkurt  Fevzi Altuntas
Affiliation:1. Istanbul Training and Research Hospital, Hematology Clinic, Istanbul, Turkey;2. Medical Park Izmir Hospital, Department of Hematology, Izmir, Turkey;3. Ankara Oncology Training and Research Hospital, Hematology and Stem Cell Transplantation Clinic, Ankara, Turkey;4. Pamukkale University Faculty of Medicine, Department of Hematology, Denizli, Turkey;5. Erciyes University Faculty of Medicine, Department of Hematology, Kayseri, Turkey;6. Inonu University Faculty of Medicine, Department of Hematology, Malatya, Turkey;7. Yildirim Beyazit University Faculty of Medicine, Department of Hematology, Ankara, Turkey
Abstract:
As known, the world population is aging and as the life span increases the number of advanced-age lymphomas also shows an upward trend. Autologous hematopoietic stem cell transplantation (HSCT) is the standard treatment modality in chemotherapy-sensitive relapsed or refractory aggressive lymphomas. Increased morbidity and mortality related to both the transplant itself and comorbid diseases can be observed in elderly lymphoma patients. Patients who are 65 years or older and underwent autologous HSCT with B-cell non-Hodgkin lymphoma were retrospectively included in our study. In terms of survival analysis, median follow-up was 34.5 months (8–159) while the overall survival (OS) was 58%. In the univariate analysis of prognostic data in OS, patients who were referred to transplantation with complete response had a statistically significant survival advantage (p = 0.043). In terms of the effect of pre-transplant conditioning regimens on survival, BEAM regimen yielded better results, though not statistically significant. Age, number of chemotherapy cycles received before mobilization and radiation therapy had no significant effect on the CD34 (+) cell count in the final product (p = 0.492, 0.746 and 0.078 respectively). In conclusion, autologous HSCT is a practicable treatment modality that provides survival advantage in suitable advanced-age patients with a diagnosis of B-cell non-Hodgkin lymphoma.
Keywords:B-cell non-Hodgkin lymphoma  Autologous hematopoietic stem cell transplantation  Elderly patients  Mobilization
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