Buadi F K, Micallef I N, Ansell S M, Porrata L F, Dispenzieri A, Elliot M A, Gastineau D A, Gertz M A, Lacy M Q, Litzow M R, Tefferi A, Inwards D J
Division of Hematology, Department of Internal Medicine, Mayo Clinic College of Medicine, 200 First Street SW, Rochester, MN 55905, USA.
Bone Marrow Transplant. 2006 Jun;37(11):1017-22. doi: 10.1038/sj.bmt.1705371.
To evaluate autologous stem cell transplant (ASCT) in older patients with intermediate grade non-Hodgkin's lymphoma (NHL), the Mayo Clinic Rochester BMT database was reviewed for all patients 60 years of age and older who received ASCT for NHL between September 1995 and February 2003. Factors evaluated included treatment-related mortality (TRM), event-free survival (EFS) and overall survival (OS). Ninety-three patients were identified, including twenty-four (26%) over the age of 70 years. Treatment-related mortality (5.4%) was not significantly different when compared to a younger cohort (2.2%). At a median follow-up of 14 months (0.6-87.6 months), the estimated median survival is 25 months (95% confidence interval (CI) 12-38) in the older group compared to 56 months (95% CI 37-75) (P=0.037) in the younger group. The estimated 4-year EFS was 38% for the older group compared to 42% in the younger cohort (P=0.1). By multivariate analysis, the only factor found to influence survival in the older group was age-adjusted International Prognostic Index at relapse, 0-1 better than 2-3 (P=0.03). Autologous stem-cell transplant can be safely performed in patients 60 years or older with chemotherapy sensitive relapsed or first partial remission NHL. The outcome may not be different from that of younger patients in terms of TRM and EFS.
为评估自体干细胞移植（ASCT）在老年中危非霍奇金淋巴瘤（NHL）患者中的应用，我们回顾了梅奥诊所罗切斯特分院骨髓移植数据库中1995年9月至2003年2月期间接受ASCT治疗的所有60岁及以上的NHL患者。评估的因素包括治疗相关死亡率（TRM）、无事件生存期（EFS）和总生存期（OS）。共识别出93例患者，其中24例（26%）年龄超过70岁。与年轻队列（2.2%）相比，治疗相关死亡率（5.4%）无显著差异。在中位随访14个月（0.6 - 87.6个月）时，老年组的估计中位生存期为25个月（95%置信区间（CI）12 - 38），而年轻组为56个月（95% CI 37 - 75）（P = 0.037）。老年组的估计4年EFS为38%，年轻队列则为42%（P = 0.1）。多因素分析显示，老年组中唯一影响生存的因素是复发时年龄校正的国际预后指数，0 - 1分优于2 - 3分（P = 0.03）。自体干细胞移植可安全地应用于60岁及以上化疗敏感的复发或首次部分缓解的NHL患者。在TRM和EFS方面，其结果可能与年轻患者无异。
