PF765 RESULTS OF AUTOLOGOUS STEM CELL TRANSPLANT (ASCT) IN PATIENTS ABOVE THE AGE OF 70 ARE COMPARABLE TO THE RESULTS IN YOUNGER PATIENTS

Abstract

Background:High dose chemotherapy and autologous stem cell transplant is an important therapeutic procedure for select solid tumours and haematological malignancies providing chance of durable remission following induction therapy and in some patient potential cure. Increasing numbers of patients above the age of 70 are offered high dose chemotherapy and Auto‐PBSCT. This retrospective analysis compares the outcomes, morbidity and mortality of Auto‐PBSCT in patients above the age of 70 to those in the age group of 65‐69.Aims:To evaluate the results of ASCT in patients with lymphoma or myeloma who were above the age of 70 yrs to the reults in matched group in the age group of 65 to 70 yr. with the aim to compare engraftment data, morbidity, mortality and overall survival.Methods:Retrospective evaluation using case notes, electonic patient records and haematology database.Results:We analysed 54 patients, ages 70 and over, and 56 patients, ages between 65 and 69 years, who received AutoPSCT from 1990 to 2018 in Haematology and Transplant Unit, The Christie NHS Foundation Trust, Manchester, UK. Median age was 71yr(70–75) and 67yr(65–69). Male to female ratio are 38:16 (>70yr) and 41:15 (65–69). The two indications for transplants are Myeloma and lymphoma. The proportions are similar for both age groups, Myeloma:Lymphoma 37(68.5%):17(31.5%) in >70yrs and 40(71.4%):16(28.6%) in 65–69yr The numbers of patients undergoing second Auto‐PBSCT are 9(17%) in >70yr and 11(20%) in 65–69yrs. The follow up period was 2 years (43d‐14.1years) in >70yrs and 4 years (41d‐16.3years) in the 65–69yrs. Median time to neutrophil engraftment (ANC>0.5) was 12 days(9–19days) and 12 days(9–21days). Median platelet recovery (>25) was 21days(10–195days) and 29 days (10–694 days). Median hospitalisation was 27 days (14–91days) and 21days (14–60days). In terms of morbidity during transplant, patients needing intensive or high dependency care was 8 (15%) in >70yr and 5(9%) in 65–69yrs). Patients requiring readmission post discharge was 14(26%) in >70yrs and 9 (16%) in younger age group.here was no difference in treatment related mortality and less than 3% in both groups.Summary/Conclusion:It is feasible to offer ASCT to patients above the age of 70 yr. Patient selection is crucial and should be based not only on the objective organ function evaluation but also the subjective assessment of transplant physician about appropriateness to undergo the ASCT therapy. The decision should be based on the individualised risk benefit ratio, risk of morbidity and expected survival benefit.image