Stem Cell Transplant May Improve Survival Among Elderly
A recent study reveals that elderly patients with relapsed non-Hodgkin’s Lymphoma (NHL) may benefit from autologous stem cell transplant. Results from the study, conducted at the M.D. Anderson Cancer Center in Texas, were recently published in Annals of Oncology.
Non-Hodgkin’s Lymphoma’s (NHL) is a cancer of the lymphatic system, which includes the spleen, thymus, tonsils, bone marrow, lymph nodes, and circulating immune cells. One of the lymphatic system’s primary functions is to produce cells called lymphocytes (white blood cells), which fight infection.
Treatment for NHL often consists of chemotherapy, radiation, or biologic therapies, which stimulates the patient’s own immune system is used to fight the cancer. In some cases stem cell transplantation is also a treatment option.
Stem cells are immature cells produced by the bone marrow that mature into various types of blood cells. An autologous transplant uses the patient’s own stem cells for the transplant: stem cells are collected before therapy and re-infused when treatment is complete. These cells then grow and mature to restore the patient’s blood cells. These new, healthy cells can reenergize the patient’s immune system. (Alternatively, an allogeneic transplant uses stem cells from a donor (related or unrelated) that match the patient’s.)
Previous research has shown that autologous stem cell transplantation is an effective treatment for NHL. Most of the research, however, has focused on younger individuals, leaving the outcomes for elderly patients poorly documented. In this study researchers focused on the outcomes of 99 patients with relapsed NHL who were age 60 or older. The patients received a combination of high-dose chemotherapy, followed by an infusion of autologous stem cells.
- The three-year survival rate among these patients was 61%.
- Treatment-related deaths occurred in 8% of patients.
- Coexisting conditions (such as the patient’s disease status, resistance to chemotherapy, and elevated blood enzymes known as LDH) were identified as adversely affecting the patient’s outcome.
- Of the 99 patients, 16% developed a secondary form of blood cancer, such as myelodysplastic syndrome or acute myelogenous leukemia, as a result of treatment.
These findings were similar to results observed previously in younger patients. An exception, however, was the high rate of secondary blood cancers. Autologous stem cell transplant may be an additional treatment consideration for elderly patients diagnosed with relapsed NHL.
Reference: Hosin, C., Saliba, RM., Okoroju G-J, et al. High dose chemotherapy and autologous hematopoietic progenitor cell transplantation for non hodgkin’s lymphoma in patients>65 years of age. Annals of Oncology [early online publication]. February 13, 2008.