Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: a single center experience
| Autor: | M Montanari, P. Leoni, Debora Capelli, Antonella Poloni, Riccardo Centurioni, Marco Candela, Attilio Olivieri, Danilo Massidda, C Tonnini, M C Masia, Marino Brunori, Moira Lucesole |
|---|---|
| Rok vydání: | 2001 |
| Předmět: |
Male
Melphalan medicine.medical_specialty Cyclophosphamide medicine.medical_treatment Hematopoietic stem cell transplantation Single Center Transplantation Autologous Surveys and Questionnaires Internal medicine Antineoplastic Combined Chemotherapy Protocols Humans Medicine Survival rate Aged Transplantation Performance status business.industry Graft Survival Hematopoietic Stem Cell Transplantation Hematology Middle Aged medicine.disease Surgery Hospitalization Survival Rate Treatment Outcome Hematologic Neoplasms Quality of Life Female business Progressive disease medicine.drug |
| Zdroj: | Bone Marrow Transplantation. 27:1189-1195 |
| ISSN: | 1476-5365 0268-3369 |
| DOI: | 10.1038/sj.bmt.1703034 |
| Popis: | Between May 1994 and May 2000, we autotransplanted 48 consecutive patients, 21 females and 27 males aged over 60 years (range: 60-78, median: 63). Sixteen patients had multiple myeloma (MM), 14 high-grade non-Hodgkin's lymphoma (HGNHL), six low-grade non-Hodgkin's lymphoma (LGNHL), nine acute myeloid leukemia (AML), one chronic lymphocytic leukemia (CLL), one Hodgkin's disease (HD) and one breast cancer; the performance status (WHO) was 0-1. Seventeen patients were in 1st CR (35.4%) and one in 2nd CR (2.1%), 25 in PR (52.1%), while five patients had been transplanted with progressive disease (10.4%); seven patients with MM received a double transplant. Patients received high-dose therapy including melphalan alone (13) or associated with other drugs (26), busulfan-cyclophosphamide (three), BEAM (11) and TBI (two). All patients took a median of 11 (range: 8-25) days to reach neutrophils >500/microl, 13 (range: 9-83) days to reach platelets > 20,000/microl and 17 (range: 11-83) days to reach platelets > 50,000/microl. Hematological toxicity, hospital stay and supportive care did not differ from those of a cohort of younger patients. At present, 31 patients are alive (14 in CR, five in PR, five in PD and seven in relapse) and 16 died from PD at a median follow-up of 37 months (1-67). Only one patient died from transplant-related toxicity. Quality of life, evaluated using a QLQ-C30 questionnaire in 25 patients at day +90, was good. In our experience PBPC mobilization and transplantation is feasible in patients aged > or = 60 years and the toxicity of this procedure is acceptable, with an early transplant-related mortality of 1.8%; therefore patients with hematological malignancies potentially curable with high-dose therapy (HDT) should also be candidates for HDT. |
| Databáze: | OpenAIRE |
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