New research has found that allogeneic hematopoietic stem cell transplantation is just as effective in patients with non-Hodgkin lymphoma who are age 65 and older as it is in patients between the ages of 55 and 64.
Although allogeneic hematopoietic stem cell transplantation (HCT) is a potentially curative therapy for patients with non-Hodgkin lymphoma (NHL), there is a lack of Medicare coverage, which has resulted in limited use among patients age 65 years or older. New research presented by investigators at the Center for International Blood and Marrow Transplant Research (CIBMTR) at the BMT Tandem Meetings found that HCT is an effective treatment for patients with NHL regardless of age.
The multi-center study compared 446 patients age 65 and older with 1183 patients between the ages of 55 and 64. Both groups consisted of patients who underwent allogeneic HCT for NHL. The researchers used the CIBMTR database to report outcomes of patients.
The study found that survival at 4 years for the older group of patients after HCT was comparable to the survival for the younger group of patients. Overall survival for the 65-plus group was 46% versus 51% for the patients aged 55 to 64. Disease relapse was also similar (42% vs 41%).
“Advances in conditioning regimens and progress in posttransplant care have allowed more patients more than 65 years old or those with comorbidities to undergo allogeneic HCT,” Nirav Shah, MD, lead author and assistant professor of medicine at the Medical College of Wisconsin’s Division of Hematology and Oncology said in a statement. “In 2017 alone, nearly 19% of transplant patients were more than 65 years old.”
Shah added that the results show that age alone should not be a determinant when considering HCT for patients with NHL.
CMS has expanded HCT coverage for myelodysplastic syndromes, sickle cell disease, myelofibrosis and multiple myeloma as long as the transplants take place within a CMS-approved clinical study meeting federal guidelines. Coverage of HCT for lymphoma is only not available for all patients.
“We are excited about these results and we look forward to using this information to help shape our strategy to reduce access barriers for Medicare beneficiaries with lymphoma,” said Susan N. Leppke, director of public and payer policy at the National Marrow Donor Program/Be The Match.