Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: A single center experience

A. Olivieri, D. Capelli, M. Montanari, M. Brunori, D. Massidda, A. Poloni, M. Lucesole, R. Centurioni, M. Candela, M. C. Masia, C. Tonnini, P. Leoni

Research output: Contribution to journalArticle

Abstract

Between May 1994 and May 2000, we autotransplanted 48 consecutive patients, 21 females and 27 males aged over 60 years (range: 60-78, median: 63). Sixteen patients had multiple myeloma (MM), 14 high-grade non-Hodgkin's lymphoma (HGNHL), six low-grade non-Hodgkin's lymphoma (LGNHL), nine acute myeloid leukemia (AML), one chronic lymphocytic leukemia (CLL), one Hodgkin's disease (HD) and one breast cancer; the performance status (WHO) was 0-1. Seventeen patients were in 1st CR (35.4%) and one in 2nd CR (2.1%), 25 in PR (52.1%), while five patients had been transplanted with progressive disease (10.4%); seven patients with MM received a double transplant. Patients received high-dose therapy including melphalan alone (13) or associated with other drugs (26), busulfan-cyclophosphamide (three), BEAM (11) and TBI (two). All patients took a median of 11 (range: 8-25) days to reach neutrophils >500/μl, 13 (range: 9-83) days to reach platelets >20000/μl and 17 (range: 11-83) days to reach platelets >50000/μl. Hematological toxicity, hospital stay and supportive care did not differ from those of a cohort of younger patients. At present, 31 patients are alive (14 in CR, five in PR, five in PD and seven in relapse) and 16 died from PD at a median follow-up of 37 months (1-67). Only one patient died from transplant-related toxicity. Quality of life, evaluated using a QLQ-C30 questionnaire in 25 patients at day +90, was good. In our experience PBPC mobilization and transplantation is feasible in patients aged ≥60 years and the toxicity of this procedure is acceptable, with an early transplant-related mortality of 1.8%; therefore patients with hematological malignancies potentially curable with high-dose therapy (HDT) should also be candidates for HDT.

Original languageEnglish
Pages (from-to)1189-1195
Number of pages7
JournalBone Marrow Transplantation
Volume27
Issue number11
DOIs
Publication statusPublished - 2001

    Fingerprint

Keywords

  • Autotransplantation
  • Elderly
  • PBSC
  • Toxicity

ASJC Scopus subject areas

  • Hematology
  • Transplantation

Cite this

Olivieri, A., Capelli, D., Montanari, M., Brunori, M., Massidda, D., Poloni, A., Lucesole, M., Centurioni, R., Candela, M., Masia, M. C., Tonnini, C., & Leoni, P. (2001). Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: A single center experience. Bone Marrow Transplantation, 27(11), 1189-1195. https://doi.org/10.1038/sj.bmt.1703034