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Age Makes Little Difference in Outcomes for Non-Hodgkin's Lymphoma Patients Receiving Chemotherapy: Presented at ASH

By Bruce Sylvester

ATLANTA, GA -- December 12, 2005 -- Older patients appear to achieve results on a par with their younger counterparts when they are treated with high-dose chemotherapy for non-Hodgkin's lymphoma.

Researchers reported these findings here on December 11^th at the 47^th Annual Meeting of the American Society of Hematology (ASH).

Tanya Wildes, MD, presenter and lead investigator, hematology/oncology fellow at the School of Medicine of Washington University in St. Louis, St. Louis, Missouri, and colleagues studied all patients with non-Hodgkin's lymphoma who relapsed and underwent autologous stem cell transplant following BEAM conditioning, which combines BCNU (carmustine), etoposide, cytosine arabinoside, and melphalan.

"Overall, there was similar transplant-related mortality [between younger and older patients]," Dr. Wildes said. "The older patients tended to have more difficulty with mucositis and slightly delayed platelet engraftment, but overall tolerated conditioning as well as their younger counterparts."

For their study, the researchers defined "elderly" patients as those over the age of 60. They examined outcomes of a mixed age group of 153 non-Hodgkin's lymphoma patients who had undergone high-dose chemotherapy at Washington University in St. Louis, Missouri. Ninety-four patients were under the age of 60 years (median 51 years) in the younger group, and 59 patients were 60 old or older (median 64 years).

Clinicians administered the same BEAM conditioning regimen to all patients, followed with an autologous stem cell transplant.

The researchers examined data on stem cell mobilization, engraftment, toxicities of conditioning, posttransplant morbidity, relapse, and mortality rates in the 2 age groups.

Results show that older patients experienced significantly more grade 3 mucositis (40% compared to 18%) and experienced more gram-negative bacteremia (20% compared to 13%) and candidemia (10% compared to 4%) than the younger group. However, experiences were similar in the 2 groups in terms of days to transplant discharge, days of neutropenic fever, and days on intravenous antibiotics.

Although the risk of treatment related mortality was somewhat higher in the older patient group (8.4% vs 5.3%), this number failed to reach statistical significance (P = .65).

Dr. Wildes also reported that relapse rates at 2 years did not differ significantly between the 2 groups (36% vs 27%). After a median follow-up period of 22 months, progression-free survival rates were comparable.

"Given how the population is aging and that the risk of lymphoma increases with age, more and more people over the age of 60 are going to require autologous stem cell transplant," said Dr. Wildes. "So if we can find ways to better support them through it, we can potentially make this a more widely applicable therapy."


[Presentation title: Comparison of Outcomes in Elderly Patients With Non-Hodgkin's Lymphoma Undergoing High-Dose Chemotherapy to Their Younger Counterparts: Greater Morbidity but No Significant Impact on Overall Survival. Session Type: Poster Session 290-II. Abstract 2086]

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