Autologous stem cell transplantation in elderly patients (≥60 years) with diffuse large B-cell lymphoma: an analysis based on data in the European Blood and Marrow Transplantation registry

Background There is currently limited experience on the feasibility and efficacy of autologous stem cell transplantation in elderly patients with diffuse large B-cell lymphoma. Design and Methods We analyzed the outcome of 2612 patients with diffuse large B-cell lymphoma treated with autologous stem cell transplantation between 2000 and 2005 and reported to the European Blood and Marrow Transplantation registry. Four hundred and sixty-three patients (18%) were >= 60 years old at the time of the transplant (median, 63 years). When compared to 2149 patients <60 years old at the time of transplantation, the elderly patients had more frequently received at least two treatment lines (76% vs. 57%, p<0.001), were less commonly in first complete remission at the time of transplantation (23% vs. 30%, p=0.005) and received their transplants later after diagnosis (median time 14 months vs. 7.5 months, p<0.001). Results Non-relapse mortality was higher in elderly patients at 100 days (4.4% vs. 2.8%), at 1 year (8.7% vs. 4.7%) an at 3 years (10.8% vs. 6.5%) (p=0.002). With a median follow-up of 12 months for the surviving patients for the elderly group and 15 months for the younger group, the risk of relapse was 38% and 32%, respectively (p=0.006). The progression-free survival was 51% and 62%, respectively, at 3 years (p<0.001). The overall survival rate was 60% vs. 70%, respectively, at 3 years (p<0.001). Conclusions Autologous stem cell transplantation is feasible in selected elderly patients with diffuse large B-cell lymphoma, although non-relapse mortality is somewhat higher than in younger patients. Both progression-free and overall survival rates are promising taking into account the generally poorer outcome of elderly patients with diffuse large B-cell lymphoma.