Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival

Brian L. McClune; Kwang Woo Ahn; Hai Lin Wang; Joseph H. Antin; Andrew S. Artz; Jean Yves Cahn; Abhinav Deol; César O. Freytes; Mehdi Hamadani; Leona A. Holmberg; Madan H. Jagasia; Ann A. Jakubowski; Mohamed A. Kharfan-Dabaja; Hillard M. Lazarus; Alan M. Miller; Richard Olsson; Tanya L. Pedersen; Joseph Pidala; Michael A. Pulsipher; Jacob M. Rowe; Wael Saber; Koen W. van Besien; Edmund K. Waller; Mahmoud D. Aljurf; Görgun Akpek; Ulrike Bacher; Nelson J. Chao; Yi Bin Chen; Brenda W. Cooper; Jason Dehn; Marcos J. de Lima; Jack W. Hsu; Ian D. Lewis; David I. Marks; Joseph McGuirk; Mitchell S. Cairo; Harry C. Schouten; Jeffrey Szer; Muthalagu Ramanathan; Bipin N. Savani; Matthew Seftel; Gérard Socie; Ravi Vij; Erica D. Warlick; Daniel J. Weisdorf

doi:10.1016/j.bbmt.2014.03.013

Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival

Brian L. McClune, Kwang Woo Ahn, Hai Lin Wang, Joseph H. Antin, Andrew S. Artz, Jean Yves Cahn, Abhinav Deol, César O. Freytes, Mehdi Hamadani, Leona A. Holmberg, Madan H. Jagasia, Ann A. Jakubowski, Mohamed A. Kharfan-Dabaja, Hillard M. Lazarus, Alan M. Miller, Richard Olsson, Tanya L. Pedersen, Joseph Pidala, Michael A. Pulsipher, Jacob M. RoweWael Saber, Koen W. van Besien, Edmund K. Waller, Mahmoud D. Aljurf, Görgun Akpek, Ulrike Bacher, Nelson J. Chao, Yi Bin Chen, Brenda W. Cooper, Jason Dehn, Marcos J. de Lima, Jack W. Hsu, Ian D. Lewis, David I. Marks, Joseph McGuirk, Mitchell S. Cairo, Harry C. Schouten, Jeffrey Szer, Muthalagu Ramanathan, Bipin N. Savani, Matthew Seftel, Gérard Socie, Ravi Vij, Erica D. Warlick, Daniel J. Weisdorf

Research output: Contribution to journal › Article › peer-review

27 Scopus citations

Abstract

Non-Hodgkin lymphoma (NHL) disproportionately affects older patients, who do not often undergo allogeneic hematopoietic cell transplantation (HCT). We analyzed Center for International Blood and Marrow Transplant Research data on 1248 patients age ≥40 years receiving reduced-intensity conditioning (RIC) or nonmyeloablative (NMA) conditioning HCT for aggressive (n = 668) or indolent (n = 580) NHL. Aggressive lymphoma was more frequent in the oldest cohort 49% for age 40 to 54 versus 57% for age 55 to 64 versus 67% for age ≥65; P =.0008). Fewer patients aged ≥65 had previous autografting (26% versus 24% versus 9%; P =.002). Rates of relapse, acute and chronic GVHD, and nonrelapse mortality (NRM) at 1 year post-HCT were similar in the 3 age cohorts (22% [95% confidence interval (CI), 19% to 26%] for age 40 to 54, 27% [95% CI, 23% to 31%] for age 55 to 64, and 34% [95% CI, 24% to 44%] for age ≥65. Progression-free survival (PFS) and overall survival (OS) at 3 years was slightly lower in the older cohorts (OS: 54% [95% CI, 50% to 58%] for age 40 to 54; 40% [95% CI, 36% to 44%] for age 55 to 64, and 39% [95% CI, 28% to 50%] for age ≥65; P <.0001). Multivariate analysis revealed no significant effect of age on the incidence of acute or chronic GVHD or relapse. Age ≥55 years, Karnofsky Performance Status <80, and HLA mismatch adversely affected NRM, PFS, and OS. Disease status at HCT, but not histological subtype, was associated with worse NRM, relapse, PFS, and OS. Even for patients age ≥55 years, OS still approached 40% at 3 years, suggesting that HCT affects long-term remission and remains underused in qualified older patients with NHL.

Original language	English (US)
Pages (from-to)	960-968
Number of pages	9
Journal	Biology of Blood and Marrow Transplantation
Volume	20
Issue number	7
DOIs	https://doi.org/10.1016/j.bbmt.2014.03.013
State	Published - Jul 2014

Keywords

Allogeneic
Elderly
Hematopoietic cell transplantation
Lymphoma
Nonmyeloablative
Reduced intensity

ASJC Scopus subject areas

Hematology
Transplantation

Access to Document

10.1016/j.bbmt.2014.03.013

Fingerprint Dive into the research topics of 'Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival'. Together they form a unique fingerprint.

Cite this

McClune, B. L., Ahn, K. W., Wang, H. L., Antin, J. H., Artz, A. S., Cahn, J. Y., Deol, A., Freytes, C. O., Hamadani, M., Holmberg, L. A., Jagasia, M. H., Jakubowski, A. A., Kharfan-Dabaja, M. A., Lazarus, H. M., Miller, A. M., Olsson, R., Pedersen, T. L., Pidala, J., Pulsipher, M. A., ... Weisdorf, D. J. (2014). Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival. Biology of Blood and Marrow Transplantation, 20(7), 960-968. https://doi.org/10.1016/j.bbmt.2014.03.013

Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma : Encouraging Progression-Free Survival. / McClune, Brian L.; Ahn, Kwang Woo; Wang, Hai Lin; Antin, Joseph H.; Artz, Andrew S.; Cahn, Jean Yves; Deol, Abhinav; Freytes, César O.; Hamadani, Mehdi; Holmberg, Leona A.; Jagasia, Madan H.; Jakubowski, Ann A.; Kharfan-Dabaja, Mohamed A.; Lazarus, Hillard M.; Miller, Alan M.; Olsson, Richard; Pedersen, Tanya L.; Pidala, Joseph; Pulsipher, Michael A.; Rowe, Jacob M.; Saber, Wael; van Besien, Koen W.; Waller, Edmund K.; Aljurf, Mahmoud D.; Akpek, Görgun; Bacher, Ulrike; Chao, Nelson J.; Chen, Yi Bin; Cooper, Brenda W.; Dehn, Jason; de Lima, Marcos J.; Hsu, Jack W.; Lewis, Ian D.; Marks, David I.; McGuirk, Joseph; Cairo, Mitchell S.; Schouten, Harry C.; Szer, Jeffrey; Ramanathan, Muthalagu; Savani, Bipin N.; Seftel, Matthew; Socie, Gérard; Vij, Ravi; Warlick, Erica D.; Weisdorf, Daniel J.

In: Biology of Blood and Marrow Transplantation, Vol. 20, No. 7, 07.2014, p. 960-968.

Research output: Contribution to journal › Article › peer-review

McClune, BL, Ahn, KW, Wang, HL, Antin, JH, Artz, AS, Cahn, JY, Deol, A, Freytes, CO, Hamadani, M, Holmberg, LA, Jagasia, MH, Jakubowski, AA, Kharfan-Dabaja, MA, Lazarus, HM, Miller, AM, Olsson, R, Pedersen, TL, Pidala, J, Pulsipher, MA, Rowe, JM, Saber, W, van Besien, KW, Waller, EK, Aljurf, MD, Akpek, G, Bacher, U, Chao, NJ, Chen, YB, Cooper, BW, Dehn, J, de Lima, MJ, Hsu, JW, Lewis, ID, Marks, DI, McGuirk, J, Cairo, MS, Schouten, HC, Szer, J, Ramanathan, M, Savani, BN, Seftel, M, Socie, G, Vij, R, Warlick, ED & Weisdorf, DJ 2014, 'Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival', Biology of Blood and Marrow Transplantation, vol. 20, no. 7, pp. 960-968. https://doi.org/10.1016/j.bbmt.2014.03.013

McClune, Brian L. ; Ahn, Kwang Woo ; Wang, Hai Lin ; Antin, Joseph H. ; Artz, Andrew S. ; Cahn, Jean Yves ; Deol, Abhinav ; Freytes, César O. ; Hamadani, Mehdi ; Holmberg, Leona A. ; Jagasia, Madan H. ; Jakubowski, Ann A. ; Kharfan-Dabaja, Mohamed A. ; Lazarus, Hillard M. ; Miller, Alan M. ; Olsson, Richard ; Pedersen, Tanya L. ; Pidala, Joseph ; Pulsipher, Michael A. ; Rowe, Jacob M. ; Saber, Wael ; van Besien, Koen W. ; Waller, Edmund K. ; Aljurf, Mahmoud D. ; Akpek, Görgun ; Bacher, Ulrike ; Chao, Nelson J. ; Chen, Yi Bin ; Cooper, Brenda W. ; Dehn, Jason ; de Lima, Marcos J. ; Hsu, Jack W. ; Lewis, Ian D. ; Marks, David I. ; McGuirk, Joseph ; Cairo, Mitchell S. ; Schouten, Harry C. ; Szer, Jeffrey ; Ramanathan, Muthalagu ; Savani, Bipin N. ; Seftel, Matthew ; Socie, Gérard ; Vij, Ravi ; Warlick, Erica D. ; Weisdorf, Daniel J. / Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma : Encouraging Progression-Free Survival. In: Biology of Blood and Marrow Transplantation. 2014 ; Vol. 20, No. 7. pp. 960-968.

@article{360fdb7e2fdf4124aee2d21d044d05c2,

title = "Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma: Encouraging Progression-Free Survival",

abstract = "Non-Hodgkin lymphoma (NHL) disproportionately affects older patients, who do not often undergo allogeneic hematopoietic cell transplantation (HCT). We analyzed Center for International Blood and Marrow Transplant Research data on 1248 patients age ≥40 years receiving reduced-intensity conditioning (RIC) or nonmyeloablative (NMA) conditioning HCT for aggressive (n = 668) or indolent (n = 580) NHL. Aggressive lymphoma was more frequent in the oldest cohort 49% for age 40 to 54 versus 57% for age 55 to 64 versus 67% for age ≥65; P =.0008). Fewer patients aged ≥65 had previous autografting (26% versus 24% versus 9%; P =.002). Rates of relapse, acute and chronic GVHD, and nonrelapse mortality (NRM) at 1 year post-HCT were similar in the 3 age cohorts (22% [95% confidence interval (CI), 19% to 26%] for age 40 to 54, 27% [95% CI, 23% to 31%] for age 55 to 64, and 34% [95% CI, 24% to 44%] for age ≥65. Progression-free survival (PFS) and overall survival (OS) at 3 years was slightly lower in the older cohorts (OS: 54% [95% CI, 50% to 58%] for age 40 to 54; 40% [95% CI, 36% to 44%] for age 55 to 64, and 39% [95% CI, 28% to 50%] for age ≥65; P <.0001). Multivariate analysis revealed no significant effect of age on the incidence of acute or chronic GVHD or relapse. Age ≥55 years, Karnofsky Performance Status <80, and HLA mismatch adversely affected NRM, PFS, and OS. Disease status at HCT, but not histological subtype, was associated with worse NRM, relapse, PFS, and OS. Even for patients age ≥55 years, OS still approached 40% at 3 years, suggesting that HCT affects long-term remission and remains underused in qualified older patients with NHL.",

keywords = "Allogeneic, Elderly, Hematopoietic cell transplantation, Lymphoma, Nonmyeloablative, Reduced intensity",

author = "McClune, {Brian L.} and Ahn, {Kwang Woo} and Wang, {Hai Lin} and Antin, {Joseph H.} and Artz, {Andrew S.} and Cahn, {Jean Yves} and Abhinav Deol and Freytes, {C{\'e}sar O.} and Mehdi Hamadani and Holmberg, {Leona A.} and Jagasia, {Madan H.} and Jakubowski, {Ann A.} and Kharfan-Dabaja, {Mohamed A.} and Lazarus, {Hillard M.} and Miller, {Alan M.} and Richard Olsson and Pedersen, {Tanya L.} and Joseph Pidala and Pulsipher, {Michael A.} and Rowe, {Jacob M.} and Wael Saber and {van Besien}, {Koen W.} and Waller, {Edmund K.} and Aljurf, {Mahmoud D.} and G{\"o}rgun Akpek and Ulrike Bacher and Chao, {Nelson J.} and Chen, {Yi Bin} and Cooper, {Brenda W.} and Jason Dehn and {de Lima}, {Marcos J.} and Hsu, {Jack W.} and Lewis, {Ian D.} and Marks, {David I.} and Joseph McGuirk and Cairo, {Mitchell S.} and Schouten, {Harry C.} and Jeffrey Szer and Muthalagu Ramanathan and Savani, {Bipin N.} and Matthew Seftel and G{\'e}rard Socie and Ravi Vij and Warlick, {Erica D.} and Weisdorf, {Daniel J.}",

year = "2014",

month = jul,

doi = "10.1016/j.bbmt.2014.03.013",

language = "English (US)",

volume = "20",

pages = "960--968",

journal = "Biology of Blood and Marrow Transplantation",

issn = "1083-8791",

publisher = "Elsevier Inc.",

number = "7",

}

TY - JOUR

T1 - Allotransplantation for Patients Age ≥40 Years with Non-Hodgkin Lymphoma

T2 - Encouraging Progression-Free Survival

AU - McClune, Brian L.

AU - Ahn, Kwang Woo

AU - Wang, Hai Lin

AU - Antin, Joseph H.

AU - Artz, Andrew S.

AU - Cahn, Jean Yves

AU - Deol, Abhinav

AU - Freytes, César O.

AU - Hamadani, Mehdi

AU - Holmberg, Leona A.

AU - Jagasia, Madan H.

AU - Jakubowski, Ann A.

AU - Kharfan-Dabaja, Mohamed A.

AU - Lazarus, Hillard M.

AU - Miller, Alan M.

AU - Olsson, Richard

AU - Pedersen, Tanya L.

AU - Pidala, Joseph

AU - Pulsipher, Michael A.

AU - Rowe, Jacob M.

AU - Saber, Wael

AU - van Besien, Koen W.

AU - Waller, Edmund K.

AU - Aljurf, Mahmoud D.

AU - Akpek, Görgun

AU - Bacher, Ulrike

AU - Chao, Nelson J.

AU - Chen, Yi Bin

AU - Cooper, Brenda W.

AU - Dehn, Jason

AU - de Lima, Marcos J.

AU - Hsu, Jack W.

AU - Lewis, Ian D.

AU - Marks, David I.

AU - McGuirk, Joseph

AU - Cairo, Mitchell S.

AU - Schouten, Harry C.

AU - Szer, Jeffrey

AU - Ramanathan, Muthalagu

AU - Savani, Bipin N.

AU - Seftel, Matthew

AU - Socie, Gérard

AU - Vij, Ravi

AU - Warlick, Erica D.

AU - Weisdorf, Daniel J.

PY - 2014/7

Y1 - 2014/7

N2 - Non-Hodgkin lymphoma (NHL) disproportionately affects older patients, who do not often undergo allogeneic hematopoietic cell transplantation (HCT). We analyzed Center for International Blood and Marrow Transplant Research data on 1248 patients age ≥40 years receiving reduced-intensity conditioning (RIC) or nonmyeloablative (NMA) conditioning HCT for aggressive (n = 668) or indolent (n = 580) NHL. Aggressive lymphoma was more frequent in the oldest cohort 49% for age 40 to 54 versus 57% for age 55 to 64 versus 67% for age ≥65; P =.0008). Fewer patients aged ≥65 had previous autografting (26% versus 24% versus 9%; P =.002). Rates of relapse, acute and chronic GVHD, and nonrelapse mortality (NRM) at 1 year post-HCT were similar in the 3 age cohorts (22% [95% confidence interval (CI), 19% to 26%] for age 40 to 54, 27% [95% CI, 23% to 31%] for age 55 to 64, and 34% [95% CI, 24% to 44%] for age ≥65. Progression-free survival (PFS) and overall survival (OS) at 3 years was slightly lower in the older cohorts (OS: 54% [95% CI, 50% to 58%] for age 40 to 54; 40% [95% CI, 36% to 44%] for age 55 to 64, and 39% [95% CI, 28% to 50%] for age ≥65; P <.0001). Multivariate analysis revealed no significant effect of age on the incidence of acute or chronic GVHD or relapse. Age ≥55 years, Karnofsky Performance Status <80, and HLA mismatch adversely affected NRM, PFS, and OS. Disease status at HCT, but not histological subtype, was associated with worse NRM, relapse, PFS, and OS. Even for patients age ≥55 years, OS still approached 40% at 3 years, suggesting that HCT affects long-term remission and remains underused in qualified older patients with NHL.

AB - Non-Hodgkin lymphoma (NHL) disproportionately affects older patients, who do not often undergo allogeneic hematopoietic cell transplantation (HCT). We analyzed Center for International Blood and Marrow Transplant Research data on 1248 patients age ≥40 years receiving reduced-intensity conditioning (RIC) or nonmyeloablative (NMA) conditioning HCT for aggressive (n = 668) or indolent (n = 580) NHL. Aggressive lymphoma was more frequent in the oldest cohort 49% for age 40 to 54 versus 57% for age 55 to 64 versus 67% for age ≥65; P =.0008). Fewer patients aged ≥65 had previous autografting (26% versus 24% versus 9%; P =.002). Rates of relapse, acute and chronic GVHD, and nonrelapse mortality (NRM) at 1 year post-HCT were similar in the 3 age cohorts (22% [95% confidence interval (CI), 19% to 26%] for age 40 to 54, 27% [95% CI, 23% to 31%] for age 55 to 64, and 34% [95% CI, 24% to 44%] for age ≥65. Progression-free survival (PFS) and overall survival (OS) at 3 years was slightly lower in the older cohorts (OS: 54% [95% CI, 50% to 58%] for age 40 to 54; 40% [95% CI, 36% to 44%] for age 55 to 64, and 39% [95% CI, 28% to 50%] for age ≥65; P <.0001). Multivariate analysis revealed no significant effect of age on the incidence of acute or chronic GVHD or relapse. Age ≥55 years, Karnofsky Performance Status <80, and HLA mismatch adversely affected NRM, PFS, and OS. Disease status at HCT, but not histological subtype, was associated with worse NRM, relapse, PFS, and OS. Even for patients age ≥55 years, OS still approached 40% at 3 years, suggesting that HCT affects long-term remission and remains underused in qualified older patients with NHL.

KW - Allogeneic

KW - Elderly

KW - Hematopoietic cell transplantation

KW - Lymphoma

KW - Nonmyeloablative

KW - Reduced intensity

UR - http://www.scopus.com/inward/record.url?scp=84902120179&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84902120179&partnerID=8YFLogxK

U2 - 10.1016/j.bbmt.2014.03.013

DO - 10.1016/j.bbmt.2014.03.013

M3 - Article

C2 - 24641829

AN - SCOPUS:84902120179

VL - 20

SP - 960

EP - 968

JO - Biology of Blood and Marrow Transplantation

JF - Biology of Blood and Marrow Transplantation

SN - 1083-8791

IS - 7

ER -