Trends in utilization and survival after autologous hematopoietic cell transplantation in North America from 1995 to 2005: Significant improvement in survival for lymphoma and myeloma during a period of increasing recipient age.

Publication Type:

Journal Article

Source:

Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation (2013)

Keywords:

2013, Clinical Research Division, May 2013

Abstract:

Autologous hematopoietic cell transplantation (autoHCT) is used for relapsed and recurrent malignant disorders and as part of initial therapy for selected malignancies. This study describes changes in utilization, techniques and survival in a population-based cohort including 68,404 patients who underwent first autoHCT in a US or Canadian center, 1994-2005, and were reported to the Center for International Blood and Marrow Transplant Research (CIBMTR). The highest annual mean autoHCTs performed (average 6,948 annually) occurred during 1996-1999, with a subsequent decrease (average 4,783 annually), mainly due to less autoHCTs for breast cancer. However, the annual mean of autoHCTs increased from 5,278 annually in 1994-1995 to 5,459 annually in 2004-2005, reflecting increased utilization for multiple myeloma (MM), non-Hodgkin (NHL) and Hodgkin lymphoma (HL). Despite an increase in the median age from 44 to 53 years, there has been a significant improvement in OS from 1994 to 2005 for patients with chemotherapy-sensitive relapsed NHL (Day +100 OS: 85 to 96%; 1 year OS: 68 to 80% P<0.001) and chemotherapy-sensitive MM (Day +100 OS: 96 to 98%; 1 year OS: 83 to 92% P<0.001). The OS improvement was most pronounced in middle aged (>40 years) and older (>60 years) individuals.