Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation: a CIBMTR analysis

Nirav N. Shah, Kwang Woo Ahn, Carlos Litovich, Timothy S. Fenske, Sairah Ahmed, Minoo Battiwalla, Nelli Bejanyan, Parastoo B. Dahi, Javier Bolaños-Meade, Andy Chen, Stefan O. Ciurea, Veronika Bachanova, Zachariah DeFilipp, Narendranath Epperla, Nosha Farhadfar, Alex F. Herrera, Bradley M. Haverkos, Leona Holmberg, Nasheed M. Hossain, Mohamed A. Kharfan-DabajaVaishalee P. Kenkre, Hillard M. Lazarus, Hemant S. Murthy, Taiga Nishihori, Andrew R. Rezvani, Anita D'Souza, Bipin N. Savani, Matthew L. Ulrickson, Edmund K. Waller, Anna Sureda, Sonali M. Smith, Mehdi Hamadani

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

The application of allogeneic hematopoietic cell transplantation (allo-HCT) in non-Hodgkin lymphoma (NHL) patients ≥65 years in the United States is limited by lack of Medicare coverage for this indication. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we report allo-HCT outcomes of NHL patients aged ≥65 years (older cohort; n = 446) compared with a cohort of younger NHL patients aged 55-64 years (n = 1183). We identified 1629 NHL patients undergoing a first reduced-intensity conditioning (RIC) or nonmyeloablative conditioning allo-HCT from 2008 to 2015 in the United States. Cord blood or haploidentical transplants were excluded. The median age was 68 years (range 65-77) for the older cohort vs 60 years (range 55-64) in the younger cohort. The 4-year adjusted probabilities of nonrelapse mortality (NRM), relapse/progression (R/P), progression-free survival (PFS), and overall survival (OS) of the younger and older groups were 24% vs 30% (P = .03), 41% vs 42% (P = .82), 37% vs 31% (P = .03), and 51% vs 46% (P = .07), respectively. Using multivariate analysis, compared with the younger group, the older cohort was associated with increased NRM, but there was no difference between the 2 cohorts in terms of R/P, PFS, or OS. The most common cause of death was disease relapse in both groups. In NHL patients eligible for allo-HCT, there was no difference in OS between the 2 cohorts. Age alone should not determine allo-HCT eligibility in NHL, and Medicare should expand allo-HCT coverage to older adults.

Original languageEnglish (US)
Pages (from-to)933-940
Number of pages8
JournalBlood advances
Volume2
Issue number8
DOIs
StatePublished - Apr 24 2018

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Cell Transplantation
Homologous Transplantation
Medicare
Non-Hodgkin's Lymphoma
Bone Marrow
Transplants
Research
Recurrence
Disease-Free Survival
Survival
Mortality
Fetal Blood
Cause of Death
Multivariate Analysis
Databases

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Shah, N. N., Ahn, K. W., Litovich, C., Fenske, T. S., Ahmed, S., Battiwalla, M., ... Hamadani, M. (2018). Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation: a CIBMTR analysis. Blood advances, 2(8), 933-940. https://doi.org/10.1182/bloodadvances.2018018531

Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation : a CIBMTR analysis. / Shah, Nirav N.; Ahn, Kwang Woo; Litovich, Carlos; Fenske, Timothy S.; Ahmed, Sairah; Battiwalla, Minoo; Bejanyan, Nelli; Dahi, Parastoo B.; Bolaños-Meade, Javier; Chen, Andy; Ciurea, Stefan O.; Bachanova, Veronika; DeFilipp, Zachariah; Epperla, Narendranath; Farhadfar, Nosha; Herrera, Alex F.; Haverkos, Bradley M.; Holmberg, Leona; Hossain, Nasheed M.; Kharfan-Dabaja, Mohamed A.; Kenkre, Vaishalee P.; Lazarus, Hillard M.; Murthy, Hemant S.; Nishihori, Taiga; Rezvani, Andrew R.; D'Souza, Anita; Savani, Bipin N.; Ulrickson, Matthew L.; Waller, Edmund K.; Sureda, Anna; Smith, Sonali M.; Hamadani, Mehdi.

In: Blood advances, Vol. 2, No. 8, 24.04.2018, p. 933-940.

Research output: Contribution to journalArticle

Shah, NN, Ahn, KW, Litovich, C, Fenske, TS, Ahmed, S, Battiwalla, M, Bejanyan, N, Dahi, PB, Bolaños-Meade, J, Chen, A, Ciurea, SO, Bachanova, V, DeFilipp, Z, Epperla, N, Farhadfar, N, Herrera, AF, Haverkos, BM, Holmberg, L, Hossain, NM, Kharfan-Dabaja, MA, Kenkre, VP, Lazarus, HM, Murthy, HS, Nishihori, T, Rezvani, AR, D'Souza, A, Savani, BN, Ulrickson, ML, Waller, EK, Sureda, A, Smith, SM & Hamadani, M 2018, 'Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation: a CIBMTR analysis', Blood advances, vol. 2, no. 8, pp. 933-940. https://doi.org/10.1182/bloodadvances.2018018531
Shah, Nirav N. ; Ahn, Kwang Woo ; Litovich, Carlos ; Fenske, Timothy S. ; Ahmed, Sairah ; Battiwalla, Minoo ; Bejanyan, Nelli ; Dahi, Parastoo B. ; Bolaños-Meade, Javier ; Chen, Andy ; Ciurea, Stefan O. ; Bachanova, Veronika ; DeFilipp, Zachariah ; Epperla, Narendranath ; Farhadfar, Nosha ; Herrera, Alex F. ; Haverkos, Bradley M. ; Holmberg, Leona ; Hossain, Nasheed M. ; Kharfan-Dabaja, Mohamed A. ; Kenkre, Vaishalee P. ; Lazarus, Hillard M. ; Murthy, Hemant S. ; Nishihori, Taiga ; Rezvani, Andrew R. ; D'Souza, Anita ; Savani, Bipin N. ; Ulrickson, Matthew L. ; Waller, Edmund K. ; Sureda, Anna ; Smith, Sonali M. ; Hamadani, Mehdi. / Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation : a CIBMTR analysis. In: Blood advances. 2018 ; Vol. 2, No. 8. pp. 933-940.
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abstract = "The application of allogeneic hematopoietic cell transplantation (allo-HCT) in non-Hodgkin lymphoma (NHL) patients ≥65 years in the United States is limited by lack of Medicare coverage for this indication. Using the Center for International Blood and Marrow Transplant Research (CIBMTR) database, we report allo-HCT outcomes of NHL patients aged ≥65 years (older cohort; n = 446) compared with a cohort of younger NHL patients aged 55-64 years (n = 1183). We identified 1629 NHL patients undergoing a first reduced-intensity conditioning (RIC) or nonmyeloablative conditioning allo-HCT from 2008 to 2015 in the United States. Cord blood or haploidentical transplants were excluded. The median age was 68 years (range 65-77) for the older cohort vs 60 years (range 55-64) in the younger cohort. The 4-year adjusted probabilities of nonrelapse mortality (NRM), relapse/progression (R/P), progression-free survival (PFS), and overall survival (OS) of the younger and older groups were 24{\%} vs 30{\%} (P = .03), 41{\%} vs 42{\%} (P = .82), 37{\%} vs 31{\%} (P = .03), and 51{\%} vs 46{\%} (P = .07), respectively. Using multivariate analysis, compared with the younger group, the older cohort was associated with increased NRM, but there was no difference between the 2 cohorts in terms of R/P, PFS, or OS. The most common cause of death was disease relapse in both groups. In NHL patients eligible for allo-HCT, there was no difference in OS between the 2 cohorts. Age alone should not determine allo-HCT eligibility in NHL, and Medicare should expand allo-HCT coverage to older adults.",
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T1 - Outcomes of Medicare-age eligible NHL patients receiving RIC allogeneic transplantation

T2 - a CIBMTR analysis

AU - Shah, Nirav N.

AU - Ahn, Kwang Woo

AU - Litovich, Carlos

AU - Fenske, Timothy S.

AU - Ahmed, Sairah

AU - Battiwalla, Minoo

AU - Bejanyan, Nelli

AU - Dahi, Parastoo B.

AU - Bolaños-Meade, Javier

AU - Chen, Andy

AU - Ciurea, Stefan O.

AU - Bachanova, Veronika

AU - DeFilipp, Zachariah

AU - Epperla, Narendranath

AU - Farhadfar, Nosha

AU - Herrera, Alex F.

AU - Haverkos, Bradley M.

AU - Holmberg, Leona

AU - Hossain, Nasheed M.

AU - Kharfan-Dabaja, Mohamed A.

AU - Kenkre, Vaishalee P.

AU - Lazarus, Hillard M.

AU - Murthy, Hemant S.

AU - Nishihori, Taiga

AU - Rezvani, Andrew R.

AU - D'Souza, Anita

AU - Savani, Bipin N.

AU - Ulrickson, Matthew L.

AU - Waller, Edmund K.

AU - Sureda, Anna

AU - Smith, Sonali M.

AU - Hamadani, Mehdi

PY - 2018/4/24

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