Age May Influence Long-Term Outcome of Bone-Marrow Transplants: Presented at ASH
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Age May Influence Long-Term Outcome of Bone-Marrow Transplants: Presented at ASH

By Arushi Sinha

SAN FRANCISCO -- December 9, 2008 -- Age may play a key role in the long-term outcome of patients with non-Hodgkin's lymphoma (NHL) undergoing autologous bone-marrow and stem-cell transplantation (ABMT), researchers noted at the American Society of Hematology (ASH) 50th Annual Meeting and Exposition.

"We know for NHL patients and for patients in the relapse setting that autologous stem-cell transplants are effective," noted Hien Duong, MD, Cleveland Clinic Taussig Cancer Institute, Cleveland, Ohio. "It was not previously thought that age might be a prognostic indicator."

Dr. Duong presented his team's 15-year, longitudinal analysis of post-ABMT outcomes among NHL patients here on December 7.

The research team identified 110 NHL patients who had undergone a uniform ABMT procedure between 1988 and 1993. They found that 38 patients were still available for follow-up, and 72 patients had died. At the time of transplantation, the median patient age was 47 years.

During the follow-up period, the researchers found that 2 variables at time of transplant -- sensitivity to chemotherapy and lactate dehydrogenase (LDH) status -- were significant predictors of long-term outcome. It was found that 85% of patients demonstrated sensitivity to salvage chemotherapy, and 31% exhibited elevated LDH levels. Histological profiles demonstrated 21% patients with low-grade cytology, 54% with intermediate-grade cytology, and 25% with high-grade cytology.

Age at transplant was also found to be a significant predictor of outcome (P = .002). The team further found that the younger age group had a lower incidence of relapse-associated mortality. For patients aged 40 to 67 years, the relapse mortality rate was approximately 60% compared with approximately 35% for patients aged 20 to 39 at time of transplant (P = .039).

Based upon these findings, the authors suggested that age at transplant may play a key role in long-term outcome. This finding may add to the body of knowledge when considering transplants in NHL patients.

The authors also noted that continued and extended surveillance may be beneficial in better understanding any additional long-term effects of treatment.

[Presentation title: 15 Year Follow-Up of ABMT for NHL: Surprisingly Favorable Outcome for Younger Adults. Abstract 2183]

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