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Mortality Patterns Among Recipients of Autologous Hematopoietic Stem Cell Transplantation for Lymphoma and Myeloma in the Past Three Decades
Bhatt, Vijaya Raj1; Loberiza, Fausto R., Jr.1; Jing, Hongmei2; Bociek, R. Gregory1; Bierman, Philip J.1; Maness, Lori J.1; Vose, Julie M.1; Armitage, James O.1; Akhtari, Mojtaba1
关键词Autologous Stem Cell Transplantation Causes Of Death Hodgkin Lymphoma Multiple Myeloma Non-hodgkin Lymphoma
刊名CLINICAL LYMPHOMA MYELOMA & LEUKEMIA
2015-07-01
DOI10.1016/j.clml.2015.02.024
15期:7页:409-415
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Oncology ; Hematology
研究领域[WOS]Oncology ; Hematology
关键词[WOS]BONE-MARROW-TRANSPLANTATION ; HIGH-DOSE CHEMOTHERAPY ; REFRACTORY MANTLE-CELL ; NON-HODGKIN-LYMPHOMA ; RELAPSED FOLLICULAR LYMPHOMA ; DIAGNOSED MULTIPLE-MYELOMA ; PROGRESSION-FREE SURVIVAL ; COLONY-STIMULATING FACTOR ; MULTICENTER PHASE-II ; RANDOMIZED-TRIAL
英文摘要

We performed a retrospective study of patients with lymphoma and myeloma, aged 18 years, who had undergone autologous stem cell transplantation (ASCT) from 1983 to 2010 at the University of Nebraska Medical Center. Of the 2284 patients, 972 died within the first 5 years after ASCT. Disease relapse (73.4%), organ failure (7.8%), infection (4.7%), and secondary malignancy (4.2%) accounted for most of the deaths. The risk of death from infection (P < .0001), but not from relapse (P = .26), organ failure (P = .68), or secondary malignancy (P = .15), declined in the more recent cohorts. The mortality from relapse remained the most common cause of death.

Background: Understanding the mortality patterns of patients with lymphoma and myeloma, who have undergone autologous hematopoietic stem cell transplantation (ASCT) might identify improvement opportunities. Patients and Methods: The present retrospective study included patients with lymphoma and myeloma, aged >= 18 years, who had undergone ASCT from 1983 to 2010 at the University of Nebraska Medical Center. Of the 2284 patients, 972 had died within first 5 years after ASCT. The patients were divided into 3 cohorts according to the time of transplantation: 1983 to 1990 (cohort I), 1991 to 2000 (cohort II), and 2001 to 2010 (cohort III). Using Cox proportional hazards regression analysis, the risk of cause-specific mortality was compared across the 3 cohorts. Results: Of a total of 1215 deaths, 972 (80%) occurred within the first 5 years after ASCT. Disease relapse (73.4%), organ failure (7.8%), infection (4.7%), and secondary malignancy (4.2%) accounted for most of the deaths. The risk of death from infection (P < .0001), but not from relapse P = .26), organ failure (P = .68), or secondary malignancy P = .15), had declined in the more recent cohorts. Conclusion: The 5-year overall survival of patients undergoing ASCT has improved significantly owing to a decline in infectious mortality. Our results highlight that the mortality from relapse remains the most common cause of death, warranting investigation of different strategies to reduce the incidence of relapse and improve the therapy for relapse after ASCT. (C) 2015 Elsevier Inc. All rights reserved.

语种英语
WOS记录号WOS:000357967700005
资助机构Ziopharm Oncology ; GlaxoSmithKline ; Spectrum Pharmaceuticals ; Roche ; Spectrum ; ARIAD
引用统计
被引频次:6[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/55022
专题北京大学第三临床医学院_血液内科
作者单位1.Univ Nebraska Med Ctr, Dept Internal Med, Div Hematol Oncol, Omaha, NE 68198 USA
2.Peking Univ, Dept Hematol, Hosp 3, Beijing, Peoples R China
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Bhatt, Vijaya Raj,Loberiza, Fausto R., Jr.,Jing, Hongmei,et al. Mortality Patterns Among Recipients of Autologous Hematopoietic Stem Cell Transplantation for Lymphoma and Myeloma in the Past Three Decades[J]. CLINICAL LYMPHOMA MYELOMA &amp; LEUKEMIA,2015,15(7):409-415.
APA Bhatt, Vijaya Raj.,Loberiza, Fausto R., Jr..,Jing, Hongmei.,Bociek, R. Gregory.,Bierman, Philip J..,...&Akhtari, Mojtaba.(2015).Mortality Patterns Among Recipients of Autologous Hematopoietic Stem Cell Transplantation for Lymphoma and Myeloma in the Past Three Decades.CLINICAL LYMPHOMA MYELOMA & LEUKEMIA,15(7),409-415.
MLA Bhatt, Vijaya Raj,et al."Mortality Patterns Among Recipients of Autologous Hematopoietic Stem Cell Transplantation for Lymphoma and Myeloma in the Past Three Decades".CLINICAL LYMPHOMA MYELOMA & LEUKEMIA 15.7(2015):409-415.
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