High-dose chemotherapy with autologous stem cell support in first-line treatment of aggressive non-Hodgkin lymphoma – Results of a comprehensive meta-analysis

Greb, Alexander; Bohlius, Julia; Trelle, Sven; Schiefer, Daniel; Souza, Cármino Antônio de; Gisselbrecht, Christian; Intragumtornchai, Tanin; Kaiser, Ulrich; Kluin-Nelemans, Hanneke C.; Martelli, Maurizio; Milpied, Noël; Santini, G; Verdonck, Leo F.; Vitolo, Umberto; Schwarzer, Guido; Engert, Andreas

doi:10.1016/j.ctrv.2007.02.002

Cited by 79 publications

(56 citation statements)

References 38 publications

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“…While HDT and auto-SCT is accepted as standard therapy for patients with chemosensitive relapse, its role as part of the first line therapy for high-risk DLBCL is still a matter of debate. According to a recent metaanalysis, 12 no evidence for the improved survival was found for the low-risk patients. However, the evidence for the benefit of upfront HDT for high-risk patients was found to be inconclusive as some studies have reported improved and others reduced OS and FFS in comparison to conventional CT. 12 Thus, further studies are warranted.…”

Section: Introductionmentioning

confidence: 99%

“…According to a recent metaanalysis, 12 no evidence for the improved survival was found for the low-risk patients. However, the evidence for the benefit of upfront HDT for high-risk patients was found to be inconclusive as some studies have reported improved and others reduced OS and FFS in comparison to conventional CT. 12 Thus, further studies are warranted. Identification of biologically relevant prognostic factors is also likely to clarify the role of upfront auto-SCT.…”

Section: Introductionmentioning

confidence: 99%

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Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma

Nyman

Jantunen

Juvonen

et al. 2008

Bone Marrow Transplant

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Non-germinal center (non-GC) phenotype is an adverse prognostic factor in chemotherapy (CT)-treated diffuse large B-cell lymphoma (DLBCL) patients. To determine how high-dose therapy (HDT) supported with auto-SCT as first line therapy influences GC-associated outcome in young high-risk DLBCL patients GC and non-GC phenotypes were determined immunohistochemically from 63 patients. Of these, 29 primary high-risk DLBCL patients were treated with auto-SCT, whereas 34 CT-treated patients served as a control group. Consistent with previous studies, non-GC phenotype was associated with adverse outcome in CT-treated high-risk patients. In contrast, immunohistochemical classification by cell of origin did not associate with survival after auto-SCT. When the impact of treatment on the predictive value of cell of origin was analyzed, the non-GC patients, who received HDT, had a better failure-free survival (FFS) and overall survival (OS) than the patients treated with CT alone. In multivariate analyses, both age-adjusted International Prognostic Index (aaIPI) and treatment were independent prognostic factors for FFS and OS. For the patients with GC phenotype, the influence of auto-SCT on survival was not significant. The data imply that auto-SCT can overcome the adverse prognostic impact of the non-GC phenotype in patients with high-risk DLBCL and warrant additional prospective studies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma

Nyman

Jantunen

Juvonen

et al. 2008

Bone Marrow Transplant

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“…2,[9][10][11] Indeed, as the median age of patients diagnosed with DLBCL is in the mid-60s, 1,12,13 many older individuals and others with comorbidities are in particular need of better initial therapy because they cannot tolerate intensive salvage chemotherapy with stem cell transplantation. 14 Novel therapeutic approaches beyond rituximab are, therefore, still required.…”

Section: Introductionmentioning

confidence: 99%

Lenalidomide plus cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab is safe and effective in untreated, elderly patients with diffuse large B-cell lymphoma: a phase I study by the Fondazione Italiana Linfomi

et al. 2013

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“…[3][4][5] As less than 50% of high-risk patients are cured with conventional chemotherapy, intensive approaches such as ASCT consolidation in first CR have been used. [6][7][8] Recently, the HOVON-40 study showed better disease-free survival (DFS) in high-risk DLBCL with high-dose sequential chemotherapy. Bcl-2 expression and non-GC DLBCL were associated with worse prognosis.…”

Section: Introductionmentioning

confidence: 99%

Prognostic impact of diffuse large B-cell lymphoma subgroups in patients undergoing autologous SCT

Neto

Dulley

Siqueira

et al. 2008

Bone Marrow Transplant

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A total of 53 patients aged 18-60 years with highintermediate or high-risk diffuse large B-cell lymphoma (DLBCL) were evaluated to analyze the impact of the cell of origin. Of 53 patients, 16 underwent autologous SCT (ASCT) in first remission and the rest received conventional chemotherapy. Immunohistochemistry was evaluated in 47 cases 17 were of germinal center (GC) origin and 30 were of non-GC origin. There was no survival difference between the two groups. Overall survival (OS) and disease-free survival (DFS) at 3 years were 93 and 83%, respectively, for the 14 patients who underwent ASCT. Their DFS was significantly better than that of patients who achieved CR but did not undergo ASCT. We conclude that ASCT is safe and improves the DFS of high-intermediate and high-risk DLBCL, regardless of the cell of origin. This observation should be confirmed in a larger study.

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High-dose chemotherapy with autologous stem cell support in first-line treatment of aggressive non-Hodgkin lymphoma – Results of a comprehensive meta-analysis

Cited by 79 publications

References 38 publications

Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma

Impact of germinal center and non-germinal center phenotypes on overall and failure-free survival after high-dose chemotherapy and auto-SCT in primary diffuse large B-cell lymphoma

Lenalidomide plus cyclophosphamide, doxorubicin, vincristine, prednisone and rituximab is safe and effective in untreated, elderly patients with diffuse large B-cell lymphoma: a phase I study by the Fondazione Italiana Linfomi

Prognostic impact of diffuse large B-cell lymphoma subgroups in patients undergoing autologous SCT

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