Outcomes of auto-SCT for lymphoma in subjects aged 70 years and over

The safety and efficacy of auto-SCT for lymphoma in older patients is not well established, particularly in those >= 70 years old. We performed a retrospective analysis comparing 17 auto-SCT recipients >= 70 years old with 39 recipients aged 65-69 years. Hematopoietic cell transplantation comorbidity index (HCT-CI) scores were similar in both groups. Nonrelapse mortality (NRM) was increased in patients aged 70 years and older (hazard ratio (HR) 6.04, P = 0.0029), and OS was decreased (HR 1.98, P = 0.082). 1-year NRM was 35% in patients aged >= 70 years vs 8% in those aged 65-69 years (P = 0.017). The incidence of in-hospital falls was higher in those aged >= 70 years (29 vs 8%, P = 0.047). In a secondary exploratory analysis, we found that the occurrence of in-hospital falls was strongly associated with inferior OS (HR 3.36, P = 0.0023) and NRM (HR 4.60, P = 0.009) among all patients of aged 65 years and older. We conclude that auto-SCT is feasible in older patients but that mortality rates appear increased in those over age of 70 years. In-hospital falls were correlated with higher mortality, and prevention of falls may improve outcomes. Susceptibility to falls may indicate underlying frailty and should be explored prospectively as a means of selecting older patients for auto-SCT. Bone Marrow Transplantation (2011) 46, 1219-1225; doi:10.1038/bmt.2010.289; published online 13 December 2010