Very low toxicity and good quality of life in 48 elderly patients autotransplanted for hematological malignancies: A single center experience

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). Six teen patients had multiple myeloma (MM), 14 high-grade non-Hodgkin's lympho ma (HGNHL), six low-grade non-Hodgkin's lymphoma (LGNHL), nine acute myeloi d leukemia (AML), one chronic lymphocytic leukemia (CLL), one Hodgkin's dis ease (HD) and one breast cancer; the performance status (WHO) was 0-1. Seve nteen patients were in Ist CR (35.4%) and one in 2nd CR (2.1%), 25 in PR (5 2.1%), while five patients had been transplanted with progressive disease ( 10.4%); seven patients with MM received a double transplant. Patients recei ved high-dose therapy including melphalan alone (13) or associated with oth er drugs (26), busulfan-cyclophosphamide (three), BEAM (11) and TBI (two), All patients took a median of II (range: 8-25) days to reach neutrophils >5 00/mul, 13 (range: 9-83) days to reach platelets >20000/mul and 17 (range: 11-83) days to reach platelets >50000/muL. 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 mo nths (1-67), Only one patient died from transplant-related toxicity. Qualit y of life, evaluated using a QLQ-C30 questionnaire in 25 patients at day +9 0, was good. In our experience PBPC mobilization and transplantation is fea sible in patients aged greater than or equal to 60 years and the toxicity o f this procedure is acceptable, with an early transplant-related mortality of 1.8%; therefore patients with hematological malignancies potentially cur able with high-dose therapy (HDT) should also be candidates for HDT.