Incidence and Risk Factors for Thromboembolism in Patients with Hematologic Malignancies Undergoing Allogeneic and Autologous Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 1141-1141
Author(s):  
Nicole M. Kuderer ◽  
Alok A. Khorana ◽  
Jonathan W. Friedberg ◽  
Eva Culakova ◽  
Gordon L. Phillips ◽  
...  
Keyword(s):  
Risk Factors ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Stem Cell Transplant ◽  
Multivariate Logistic Regression Analysis ◽  
Hematologic Malignancies ◽  
Cell Transplant ◽  
Multivariate Logistic Regression ◽  
Transplant Patients

Abstract Background: Thromboembolism (TE) is a common complication of hospitalized non-transplant cancer patients. To date, the extent and impact of TE in stem cell transplant patients is unknown, in part because it is considered a low risk group given the high prevalence of thrombocytopenia. The purpose of this study is to evaluate the incidence of and risk factors for TE in cancer patients undergoing stem cell transplantation. Methods: We conducted a retrospective analysis of all discharge summaries from the 115 US academic health centers reporting to the University HealthSystem Consortium from 1995 to 2002. We identified a total of 7,087 patients with hematologic malignancies undergoing allogeneic and autologous stem cell transplantation. The incidence of and risk factors for venous and arterial TE was analyzed in univariate and multivariate logistic regression analysis with adjusted odds ratios as estimates of relative risk. Results: TE was reported in 389 (5.5%) transplant patients with 4.8% patients developing venous and 0.7% arterial TE. The incidence of TE was greater in allogeneic (6.8%) compared to autologous (4.8%) transplant patients (p<0.0001). Among those receiving allogeneic transplantations, BMT patients experienced a higher rate of TE than PBSC patients (7.5% vs 5.6%; p<0.05). In multivariate logistic regression analysis, the following clinical variables were significantly associated with TE in stem call transplant patients with hematologic malignancies: gram negative sepsis (OR=1.76; 1.02–3.02; p=0.04), gram positive sepsis (OR=1.75; 1.25–2.45; p=0.001), line infections (OR=1.48; 1.11–1.97; p=0.008), central venous catheters (OR=1.74; 1.39–2.17; P<0.0001), pulmonary disease (OR=1.87; 1.47–2.37; p<0.0001), liver disease (OR=1.31; 1.01–1.70; p=0.04) and length of stay >30 days (OR=1.66; 1.30–2.13; p<0.0001). Hodgkin’s disease (OR= 0.59; 0.37–0.94; p=0.026) was associated with a lower risk of TE. In multivariate analysis, the type of transplant failed to remain an independent risk factor for TE after controlling for other transplant complications. Conclusions: This is the first substantive report on the incidence of thromboembolism in stem cell transplant patients. We found that thromboembolic events are a frequent complication in patients with hematologic malignancies undergoing stem cell transplantation. The incidence of TE is high among most subgroups studied. Prospective studies are needed to evaluate the efficacy and safety of thromboprophylaxis in this high-risk population.

Preliminary Data on Once-Daily IV Busulfan at 3.2 mg/kg/day Indicate That It Is Safe as a Component of the Conditioning Regimen for Hematopoietic Stem Cell Transplantation.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 5033-5033
Author(s):  
Mark W. Brunvand ◽  
Robert Rifkin ◽  
Jeffry V. Matous ◽  
Peter McSweeney ◽  
Scott Bearman
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Hematological Malignancies ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Transplant Patients ◽  
Daily Dose ◽  
Cell Transplants ◽  
Related Mortality

Abstract Busulfan is a useful chemotherapy in many stem cell transplant regimens. Data support the use of buslfan in transplant patients, especially if they have had prior treatment with radiation therapy. The dose of the busulfan used in myloablative stem cell transplantation has traditionally been sixteen oral doses of 1mg/kg/dose. The oral dosing has been limited by unreliable oral absorption of busulfan tablets. Transplant related mortality and incidence of venocclusive disease are directly related to high peak levels of busulfan. Relapse has been associated with low peak levels of busulfan. Recently, busulfan has become available as an IV preparation and preliminary data indicate that the peak busulfan levels are predictable via the IV administration route. The bulk of the data available on outcomes after transplantation using IV busulfan have used a QID dosing schedule of 0.8mg/kg/dose for sixteen doses. A smaller data base has utilized IV busulfan for stem cell transplantation as a single daily dose of 3.2mg/kg/day for 2–4 days. We present data on 19 patients treated at RMBMTP for hematological malignancies with the 3.2mg/kg/day dosing for stem cell transplantation. Sixteen of the 19 patients underwent allogeneic stem cell transplantation from related or unrelated donors from April 2003 to March 2004. Three patients underwent autologous stem cell transplants using the IV busulfan 3.2 mg/kg/day with cyclophosphamide 120 mg/kg total dose. None of the autologous transplant patients developed VOD or death during the first 100 days. 8 of the 16 patients undergoing allogeneic stem cell transplant have died: 4 patients died of relapsed disease, 2 died of GVHD, 1 patient died of sepsis, and 1 died of GVHD, relapse and a fungal infection. No autologous or allogeneic stem cell transplant patients died of regimen related toxicity. This single daily dose regimen has been well tolerated with no increase in transplant related mortality or VOD. The 3.2 mg/kg/day dose appears adequate to assure engraftment of allogeneic stem cells. The patients presented had high-risk hematological malignancies. Although the followup is short, the OS survival of 100% for the autologous stem cell transplants and 50% for the allogeneic stem cell transplantation is consistent with published data for transplantation of high-risk hematological malignancies. There does not appear to be a higher transplant related mortality, GVHD or VOD rate for patients treated with busulfan at 3.2 mg/kg/day as a single dose.

scholarly journals Letermovir profilaxis allogén vérképző-őssejt transzplantációban: egy hazai centrum gyakorlati tapasztalatai

2021 ◽  
Vol 54 (3) ◽  
pp. 153-157
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Allogeneic Stem Cell Transplantation ◽  
Cytomegalovirus Infection ◽  
Stem Cell Transplant ◽  
Cell Transplant ◽  
Allogeneic Stem Cell Transplant ◽  
Antiviral Compound ◽  
Transplant Patients

Összefoglaló. Bevezetés: A humán cytomegalovírus infekció direkt és indirekt szövődményei napjainkban is veszélyeztetik az allogén őssejt-transzplantációval kezelt betegeket. A széles körben alkalmazott preemptív stratégia mellett előnyös lehet a kórokozó reaktivációjának megelőzése profilaktikusan adagolt vírusellenes vegyülettel. A letermovir innovatív hatásmechanizmusú, szűk spektrumú antivirális szer, mely allogén őssejt-transzplantáltak körében végzett, placebo kontrollált klinikai vizsgálatban csökkentette a cytomegalovírus infekciók gyakoriságát és javította a túlélést. A szerzők 23, allogén őssejt-transzplantált beteg retrospektív módon gyűjtött adatait ismertetik, akik a beavatkozás kapcsán letermovir profilaxisban részesültek. A betegek több mint fele akut leukémiában szenvedett, harmaduk aktív betegséggel került transzplantációra, kétharmaduk donora haploidentikus egyezést mutatott. A letermovir adagolása során 2, azt követően további 3 személyben lépett fel cytomegalovírus infekció. Szervi érintettséggel járó cytomegalovírus betegség egyetlen esetben sem alakult ki. A megfigyelési időszak során 2 fő hunyt el, cytomegalovírustól független okok miatt. Az alkalmazhatóságot korlátozó mellékhatást nem észleltek. A letermovir a mindennapi klinikai gyakorlatban is hatékonynak és biztonságosnak bizonyult az őssejt-transzplantáltak cytomegalovírus fertőzésének megelőzésére. Summary. Introduction: Direct and indirect effects of cytomegalovirus infection remain an ongoing threat to patients treated with allogeneic stem cell transplantation. In addition to the widely used preemptive approach, prevention of viral replication with a prophylactically administered antiviral drug seems to be feasible. Letermovir, a narrow-spectrum antiviral compound with an innovative mechanism of action, has been shown to decrease the incidence of cytomegalovirus infection and to improve survival in a placebo-controlled clinical trial recruiting allogeneic stem cell transplant patients. Authors present retrospectively collected data from 23 patients receiving letermovir prophylaxis as a part of their allogeneic stem cell transplantation procedure. More than half of prophylaxed individuals had acute leukemia, a third of them underwent transplantation with an active disease and two third of the cohort had a haploidentical donor. During prophylaxis 2, subsequently further 3 patients developed a cytomegalovirus infection. No organ-specific disease could be detected. Through the observational period 2 patients have died due to causes unrelated to cytomegalovirus. No side effect interfering with drug use could be revealed. In this real-life case series letermovir has been shown to be effective and safe for the prevention of cytomegalovirus infection in allogeneic stem cell transplant patients.

Finalization of autologous stem cell transplant in complex and multirelapsed follicular lymphoma

2020 ◽  
Vol 106 (6) ◽  
pp. NP5-NP8
Author(s):  
Matteo Carella ◽  
Vittorio Stefoni ◽  
Cinzia Pellegrini ◽  
Lisa Argnani ◽  
Michele Cavo ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Follicular Lymphoma ◽  
Cell Transplantation ◽  
Stem Cell Transplant ◽  
Young Patients ◽  
High Dose ◽  
Cell Transplant ◽  
Aggressive Approach ◽  
Frequent Relapses

Background: Follicular lymphoma (FL) is characterized by frequent relapses and need for multitude lines of therapy, which includes different immunochemotherapy regimens, novel monoclonal antibodies, novel drugs, and autologous or allogenic stem cell transplant. Early use of autologous stem cell transplantation (ASCT) improves prognosis in patients with FL who may be candidates for an aggressive approach. Case presentation: We report the case of a 49-year-old woman with thrombophilia with relapsed/refractory grade 3A FL, heavily pretreated, who achieved third complete remission after high-dose chemotherapy and ASCT, despite experiencing life-threatening adverse events during her treatment history. Conclusions: Stem cell transplantation has emerged as the standard of care for young patients with FL but may be effective also in complex and multirelapsed clinical cases.

High (95%) Response Rates in Relapsed/Refractory Mantle Cell Lymphoma after R-HCVAD Alternating with R-Methotrexate/Cytarabine (R-M-A).

Blood ◽  
2005 ◽  
Vol 106 (11) ◽  
pp. 2446-2446 ◽  
Author(s):  
Jorge Enrique Romaguera ◽  
Luis E. Fayad ◽  
Michael Wang ◽  
Fernando Cabanillas ◽  
Fredrick Hagemeister ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Stem Cell Transplant ◽  
Cell Lymphoma ◽  
Previous Treatment ◽  
Median Number ◽  
Cell Transplant ◽  
Mantle Cell

Abstract Mantle cell lymphoma (MCL) has a poor prognosis. Relapsed/refractory patients must respond to salvage chemotherapy in order to receive potentially curative stem cell transplantation (SCT). A salvage regimen with higher rate of response will offer the patient a better chance of survival. We have previously reported the results of R-HCVAD alternating with R-M-A in frontline therapy of MCL (Blood, 104:40a, 2004, (Abstract #128). The current trial looked at relapsed/refractory MCL patients treated also with R-HCVAD alternating with R-M-A. Since August 2001, the trial has accrued 24 out of a planned number of 41 patients of whom 21 are evaluable for response and survival. Median age was 63 years (range 45–78) and male:female ratio was 5:1. Three patients had received previous R-HCVAD alternating with R-M-A and three patients had failed an autologous stem cell transplant. Immediate therapy prior to the study for the 21 patients included R-HCVAD/SCT (1), CHOPw/wo rituximab (8 patients), cyclophosphamide, vincristine and rituximab (1), fludarabine (1), fludarabine, mitoxantrone, dexamethasone and rituximab (2), fludarabine and cyclophosphamide (1), radiotherapy (2), gemcitabine, mitoxantrone and dexamathasone (1) ifosfamide, carboplatin, etoposide and rituximab (1), Velcade (1), gemcitabine (1), and rituximab (1). The median number of prior regimens was one (range 1–6). Responses to the previous treatment included complete response (CR; 8 patients, 38%), partial response (PR; 6 patients, 29%), and no response or progression (7 patients, 33%). Results of the trial are as follows: Median number of cycles received = 4 (range 1–7), with an overall response rate (ORR) of 95% (43% CR/Cru; 52% PR). 5/5 patients who had progressed through the previous treatment responded (1CR, 4 PR), and 2/2 patients who had no change to the prior therapy responded (2 PR’s). We evaluated 12 cases whose response in our trial was classified as PR and found that in 4 of them it was the best response achieved but another 4 were referred to transplant while the tumor was still responding and in another case treatment was still ongoing. In 3 cases toxicity precluded continuation of therapy. Five (24%) of the patients were consolidated with non-myeloablative allogeneic stem cell transplantation. Sixteen were not transplanted for the following reasons: age (2 patients), lack of donor (5), Progressive disease (2), patient refusal (4), physician’s choice (1), waiting for match (1), and lost to follow up (1). Toxicity after 81 cycles included neutropenic fever (14%), grade 4 neutropenia (58%) and grade 4 thrombocytopenia (53%). The were no deaths due to toxicity. With a median follow-up of 21 months range 5–45 months), the median failure-free survival is 18 months as compared to a median FFS of 9 months response duration with the previous therapy, with no plateau in the curve. Patients who underwent stem cell transplant were censored at the time of transplant. The high response rates achieved R-HCVAD alternating with R-M-A makes this regimen an excellent choice for induction therapy prior to stem cell transplantation.

Norovirus Infections in Patients with Hematological Diseases and After Stem Cell Transplantation; Epidemiological and Clinical Aspects.

Blood ◽  
2009 ◽  
Vol 114 (22) ◽  
pp. 2661-2661
Author(s):  
Per T. Ljungman ◽  
Per Bernell ◽  
Richard Lerner ◽  
Jonas Mattsson ◽  
Maria Rotzén Östlund ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Median Duration ◽  
Stem Cell Transplant ◽  
Positive Sample ◽  
Clinical Aspects ◽  
Cell Transplant ◽  
Hematological Diseases ◽  
Virus Excretion

Abstract Abstract 2661 Poster Board II-637 Norovirus infections have become a major practical clinical problem during the last few years causing outbreaks in many different situations including in hospitals infecting both patients and staff. These infections have also been associated with prolonged virus excretion in renal transplant recipients and a risk of mortality in the elderly. Little is known about the clinical impact of norovirus infections on patients who are severely immunosuppressed. The aim of this study was to analyze the impact of norovirus infections in patients with hematological diseases and after hematopoietic stem cell transplantation (HSCT). The laboratory records from the Clinical Microbiological Laboratory at Karolinska University Hospital were examined in order to identify patients with proven norovirus infection hospitalized on the haematology or allogeneic stem cell transplant wards from 2006 to 2009. The diagnostic methodology was based on an accredited protocol including a reverse transcription real- time PCR procedure with the use of oligonucleotide primers specific for detection of norovirus genotype 1 or 2 in separate wells. After identification of cases, the patient charts were reviewed to assess outcome, possible norovirus associated clinical complications, and delay of antitumor therapy. The duration of virus excretion was defined as the time from the first to the last positive sample. 65 patients were identified. 19 patients had NHL, 14 AML, 8 multiple myeloma, 8 non-malignant hematological disorders, 5 ALL, 5 CLL, 4 MDS, and one patient had CML. 24 patients had undergone HSCT; 22 allogeneic and 2 autologous. The median age was 63.1 (1.1–84.2). The cases occurred in two major and 3 minor clusters over the 3 year period with some additional sporadic cases occurring between the clusters. One of the haematology wards had to be closed for admission twice and one ward once since also several cases occurred among the staff. 17 of the detected viruses were typed to genogroup 2, 2 to genogroup 1, and 46 were not typed. 29 patients had only one positive sample of which 11 had a negative follow-up sample. The median duration of viral detection in the entire cohort was 2 days (1–216 days). Among the patients with more than one positive sample, the median duration was 15 days (2–216 days). 25/65 (38%) patients were PCR positive more than one week, 18 (28%) for more than two weeks, and 9 (14%) for more than four weeks. The majority of patients had minor and quickly resolved gastrointestinal symptoms. Five patients died in close temporal association with the norovirus infection (within a week). Three patients had fluid balance and electrolyte abnormalities and in of these a pre-existing renal failure worsened and the patient required dialysis. One patient died from pneumonia and one patient died from multiple causes with an end-stage malignancy. Seven patients (11%) had planned cytotoxic chemotherapy postponed; one of these patients had a delay in a planned allogeneic HSCT. We conclude that norovirus infection is a significant clinical complication to management of patients with hematological malignancies and stem cell transplant patients. Fatal outcome is possible primarily in patients with severe underlying conditions. Delay in planned chemotherapy was common and in addition the required closing of the ward presumably delaying chemotherapy for other non-infected patients. Disclosures: No relevant conflicts of interest to declare.

Phase I Study of Eltrombopag for Promoting Thrombopoiesis in Patients Undergoing Stem Cell Transplantation After Total Body Irradiation

Blood ◽  
2012 ◽  
Vol 120 (21) ◽  
pp. 219-219 ◽  
Author(s):  
Jane L. Liesveld ◽  
Gordon L. Phillips ◽  
Michael W. Becker ◽  
Louis Constine ◽  
Jonathan W. Friedberg ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Phase I ◽  
Cell Transplantation ◽  
Dose Level ◽  
Stem Cell Transplant ◽  
Conditioning Regimen ◽  
Cell Transplant ◽  
Once Daily ◽  
Total Body

Abstract Abstract 219 Purpose: Prolonged intervals of thrombocytopenia are common after stem cell transplantation, and platelet transfusions are the only temporary therapy before engraftment. Risk of thrombocytopenia is greater in patients receiving total body irradiation (TBI) in their conditioning regimen. Eltrombopag is a small-molecule, nonpeptide oral agent that functions as an agonist of the thrombopoietin receptor. It is approved by the FDA for the treatment of chronic idiopathic thrombocytopenic purpura and is being developed as a treatment for thrombocytopenia of other various etiologies. We report updated results of a Phase I clinical trial assessing the safety, pharmacokinetics (PK) and maximum tolerated dose (MTD) of once daily oral eltrombopag in patients undergoing stem cell transplantation with a conditioning regimen containing TBI ≥ 400 cGy. Methods: A Phase I dose-escalation clinical trial was conducted to evaluate the safety and PK of eltrombopag at 4 different dose levels: 75, 150, 225, and 300 mg given once daily for 27 days, starting 24–48 hours post stem cell transplantation to eligible patients ≥18 years old. Patients with various indications for stem cell transplantation, KPS ≥70%, and TBI ≥ 400 cGy were eligible. Patients receiving either an autologous (Auto) or allogeneic (Allo) stem cell transplantation from a sibling, related donor, or matched unrelated donor (MUD) were eligible. Stem cells from peripheral blood (PBSC) or bone marrow were permitted; however, cord blood stem cell transplantation was not permitted. Patients at risk of thromboembolism or with a history of thromboembolic disease in the preceding 6 months were excluded. PK sampling was obtained over a 24 hour period after the first dose of eltrombopag as well as during the second week of treatment (steady-state). Results: As of August 1 2012, a total of 19 subjects (7 AML, 4 lymphoma, 1 CML, 1 MDS, 1 myelofibrosis, 2 ALL, 1 APML, 1 Biphenotypic Leukemia and 1 CLL/SLL) were enrolled, and 15 completed protocol treatments. All 19 were PBSC transplants with 12 MUD, 6 Allo and 1 Auto. Three subjects were completed at each dose level up to 225 mg with six completing treatment at the highest dose of 300mg. Four subjects were replaced because drug compliance was less than 75%. To date, 11/19 are alive while 8/19 have died (3 related to graft vs. host disease (GVHD), 3 Infection-related and 2 related to disease progression (f/u interval: 5.7 – 30 months). No dose limiting toxicities (DLTs) have been observed. The most common adverse events (AEs) up to the 300 mg dose level were related to standard stem cell transplantation, which included low blood counts, fatigue, headache, diarrhea, nausea, peripheral edema, hypoalbuminemia, hyperglycemia, hypocalcemia, and hypomagnesemia. Possibly drug-related AEs were dry skin, rash, elevated creatinine, and hypokalemia; these were all grade 3 or less. There were 12 severe AEs observed in 8 subjects, which included infection (3/19), pulmonary embolism (PE) (1/19), acute renal failure (3/19), gastrointestinal (2/19), acute respiratory distress syndrome (1/19), pericarditis (1/19) and GvHD skin rash (1/19). Most SAEs were considered related to stem cell transplant, except one subject at 75 mg with PE possibly related to eltrombopag, but also possibly related to stem cell transplant and cancer diagnosis. The PE occurred 9 days after stopping eltrombopag at which time platelet count was 252K. Time to platelet engraftment and number of platelet transfusions were also documented for each enrolled patient. Median time to platelet engraftment for all subjects on this study was 16 days. PK data are summarized in Table 1 and Figure 1. A dose-dependent increase in plasma exposure of eltrombopag was observed; although some saturation of absorption is evident at the 300 mg dose level. (Figure 1). Conclusions: 27-day once daily dosing of eltrombopag to enhance platelet recovery for post-transplant thrombocytopenia is well tolerated, with no DLTs observed up to the 300 mg dose level. Most AEs were transplant related. PK showed proportional plasma concentration up to 225 mg daily dosing, with some saturation of drug absorption above 225 mg. Disclosures: Liesveld: Eisai: Research Funding, Speakers Bureau; Bristol-Myers Squibb: Speakers Bureau; Ariad: Honoraria. Off Label Use: Eltrombopag not approved post-transplant. Dawson:GlaxoSmithKline: Employment.

Outcomes of Autologous Stem Cell Transplantation for Lymphoma in the Elderly: A Single Center Experience

Blood ◽  
2015 ◽  
Vol 126 (23) ◽  
pp. 5505-5505
Author(s):  
Ghulam Rehman Mohyuddin ◽  
Shaun DeJarnette ◽  
Clint Divine ◽  
Tara L Lin ◽  
Leyla Shune ◽  
...  
Keyword(s):  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Autologous Stem Cell Transplantation ◽  
Pulmonary Toxicity ◽  
Stem Cell Transplant ◽  
The Elderly ◽  
Median Number ◽  
Autologous Stem Cell Transplant ◽  
Cell Transplant

Abstract INTRODUCTION: Autologous stem cell transplant (ASCT) is a potentially curative option for lymphoma, yet there remains a bias against offering this therapy to the elderly. Patients above age 65 are nearly always excluded from clinical trials with ASCT, limiting our understanding of the efficacy and toxicities of ASCT in this population. This lack of data and bias against ASCT in the elderly may delay referral for patients who may benefit from a transplant. Here, we report our single institution outcomes from all patients aged 65 and greater who underwent autologous stem cell transplant for lymphoma at our institution. DESIGN AND METHODS : We identified 93 consecutive patients ³ 65 years of age (median age 68.6 years) with lymphoma who underwent autologous stem cell transplantation at University of Kansas Medical Center from 2000 to 2015. After IRB approval, data was extracted using the institutional database. These patients had frequently received at least two treatments, were often beyond first complete remission at the time of transplantation and received their transplants later after diagnosis. Table 1 below summarizes the pre-transplant characteristics of our patients. RESULTS: All patients received G-CSF mobilized peripheral blood stem cells. Engraftment data is available for 87 out of 93 patients. Median number of days to neutrophil recovery (Absolute neutrophil count >500) was 11 (range 9-14). Median number of RBC and platelet transfusion in this group was 2 (range 0-10) and 3 (range 0-39), respectively. Non-relapse mortality at 100 days for the entire group was 2.15%. Overall survival at 100-days was 96.8%. Three patients (3.2 %) developed grade IV pulmonary toxicity and one patient developed grade IV veno-occlusive disease. With a median follow up of 744 days (41-2431), a disease free survival of 373 days was noted. In 63 patients who underwent transplant prior to 2013, 1-year and 2-year overall survival was found to be 84.2% and 72.1 respectively. Of the deaths in first year, 6 (55%) were related to relapse/progression, two (18%) due to pulmonary toxicity, 2 (18%) due to cardiac toxicity and 1 (9%) due to infection. In 17 patients (18.2%), transplant was performed completely/partially as an outpatient procedure. CONCLUSIONS: Although retrospective in nature, these results suggest that transplant related mortality in elderly patients with lymphoma is similar to historic younger cohorts. Chronological age should not be used alone in evaluating lymphoma patients for autologous stem cell transplantation. Instead, a comprehensive evaluation using Hematopoietic cell transplant comorbidity index and geriatric assessment should be used to guide decision-making. As the elderly population grows, an individualized approach to each patient considering all available treatment options is needed to make a potentially curative ASCT for high risk or relapsed lymphoma available to more patients. Table 1. No of patients (%) GenderMale Female 60 (65) 33 (35) Age at ASCT, median (range) 68.6 ( range 65-80) Hodgkin Disease Non Hodgkin Disease 5 (5) 88 (95) NHL subtypes Diffuse Large B- Cell Lymphoma Mantle Follicular Other 35 (40) 18 (20) 16 (18) 19 (22) Disease Status at ASCTCR1 CR 2 or more CRU PR Relapse1 Relapse 2 or more Primary Refractory 29 (31.2) 29 (31.2) 6 (6.5) 19 (20.4) 5 (5.4) 2 (2.2) 3 (3.2) Response to most recent chemoComplete remission Partial remission Progressive disease 64 (68.9) 19 (20.4) 10 (10.8) HCT-CI (% from those with obtained data) 0 1-2 3 or more N/A 15(19.0) 23(29.1) 41(51.9) 14 Disclosures No relevant conflicts of interest to declare.

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