High-dose chemotherapy with autologous stem cell transplantation in the first line treatment of aggressive Non-Hodgkin Lymphoma (NHL) in adults

Greb, Alexander; Bohlius, Julia; Schiefer, Daniel; Schwarzer, Guido; Schulz, H.; Engert, Andreas

doi:10.1002/14651858.cd004024.pub2

Cited by 77 publications

(66 citation statements)

References 67 publications

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“…77 Several studies evaluating its role following response to rituximabbased chemotherapy have recently been performed. (Table 1) Preliminary results of a randomized trial comparing R-CHOP-14 vs ASCT in young patients with DLBCL demonstrated no difference in outcome.…”

mentioning

confidence: 99%

Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity

Sehn

Gascoyne

2015

Blood

471

358

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Although the majority of patients with diffuse large B-cell lymphoma (DLBCL) can be cured with standard rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP), patients who fail R-CHOP have a dismal outcome. Thus, optimization of front-line therapy, as well as the development of more effective salvage strategies, remains an important objective. Advances in molecular genetics have vastly improved our understanding of the biological diversity of DLBCL and have led to the discovery of key oncogenic pathways. In addition to the major molecular designations of germinal center B-cell and activated B-cell subtypes, next-generation sequencing technologies have unveiled the remarkable complexity of DLBCL and identified unique molecular targets that may be differentially exploited for therapeutic benefit. These findings have translated into a growing list of promising novel agents. Moving forward, it is of paramount importance to recognize the heterogeneity of DLBCL and to investigate these targeted agents within patient populations who are most likely to benefit. It will be necessary to prioritize drugs that affect key driver pathways and to combine them rationally to optimize their benefit. Improved prognostication and the availability of predictive biomarkers will be crucial to allow for the possibility of individualized risk-adapted therapy.

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mentioning

confidence: 99%

Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity

Sehn

Gascoyne

2015

Blood

471

358

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“…For these aforementioned reasons, multiple sensitivity analyses were performed, and these analyses confirmed the conclusions regarding an overall [Gisselbrecht et al 2002;Greb et al 2008]. This trial was chosen for exclusion due to its exceptionally poor outcomes in patients with IPI high-risk disease receiving ASCT.…”

Section: Role Of Consolidative Asct In Dlbcl Following Induction Chemmentioning

confidence: 78%

“…The most comprehensive and recent meta-analysis of the clinical trials data regarding frontline ASCT in patients with DLBCL was authored by Greb and colleagues and published in 2008 in the Cochrane Database of Systematic Reviews [Greb et al 2008]. This meta-analysis drew data from 15 RCTs comparing OS and event-free survival (EFS) in patients with diffuse, aggressive NHL who received either frontline ASCT or chemotherapy alone.…”

Section: Role Of Consolidative Asct In Dlbcl Following Induction Chemmentioning

confidence: 99%

Consolidative autologous hematopoietic stem-cell transplantation in first remission for non-Hodgkin lymphoma: current indications and future perspective

Iams

Reddy

2014

Therapeutic Advances in Hematology

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The non-Hodgkin lymphomas (NHLs) are a heterogeneous group of diseases with variable clinical outcomes. Autologous hematopoietic stem-cell transplantation (ASCT) as frontline, consolidative therapy has been evaluated based upon histological subtype of NHL. In this review, we summarize the major clinical trials guiding the use of frontline ASCT in NHL. With the constantly changing landscape of upfront therapy and multiple promising novel agents, the ability to conduct randomized trials to evaluate the benefit of consolidative ASCT is not only challenging but may be considered by some an inept utilization of resources. Our recommendation for consolidative ASCT is based on analyzing the current available data.

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“…[27][28][29] A Cochrane review of the role of upfront HDT/auto-SCT in aggressive NHL concluded that there was no benefit to auto-SCT over chemotherapy, although not all studies reviewed included patients with BL. 30 Prospective studies in selected BL patients have reported only modest outcomes with upfront SCT. It should be noted, however, that these studies were not designed to directly compare chemotherapy with an autograft.…”

Section: Auto-sct In Blmentioning

confidence: 99%

The role of hematopoietic SCT in adult Burkitt lymphoma

Ahmed

Sureda

Aljurf

2012

Bone Marrow Transplant

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High-dose chemotherapy with autologous stem cell transplantation in the first line treatment of aggressive Non-Hodgkin Lymphoma (NHL) in adults

Abstract: . Despite higher CR rates, there is no benefit for high-dose chemotherapy with stem cell transplantation as a first line treatment in patients with aggressive NHL.

Cited by 77 publications

References 67 publications

Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity

Diffuse large B-cell lymphoma: optimizing outcome in the context of clinical and biologic heterogeneity

Consolidative autologous hematopoietic stem-cell transplantation in first remission for non-Hodgkin lymphoma: current indications and future perspective

The role of hematopoietic SCT in adult Burkitt lymphoma

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