nach oben

Medical Oncology

Erschienen in:

01.09.2011 | Original Paper

Standard chemotherapy is superior to high-dose chemotherapy with autologous stem cell transplantation on overall survival as the first-line therapy for patients with aggressive non-Hodgkin lymphoma: a meta-analysis

verfasst von: Jing Wang, Ping Zhan, Jian Ouyang, Bing Chen, Rongfu Zhou, Yonggong Yang

Erschienen in: Medical Oncology | Ausgabe 3/2011

Einloggen, um Zugang zu erhalten

Abstract

Randomized controlled trials (RCTs) have reported conflicting results on the impact of high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HDCT) as the first-line treatment for patients with aggressive non-Hodgkin lymphoma (NHL). We performed a systematic meta-analysis to assess the efficacy of HDCT compared to conventional chemotherapy in patients with aggressive NHL with regard to overall survival (OS) at 3 years. We gathered the data for our analysis from MEDLINE, EMBASE, Cochrane controlled trials register, Cochrane Library, and Science Citation Index (1/1990 to 11/2008) searches. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random effect model. Fourteen RCTs were identified that were published in full text and included a total of 2,413 patients. There was evidence that HDCT showed decreased OS (HR 1.20, 95% CI 1.05–1.37, P = 0.006) at 3 years when compared with conventional chemotherapy. The variation in OS probabilities between studies was not statistically significant (test for heterogeneity, Q = 10.14, df = 13, P = 0.683). Thus, our meta-analysis showed that HDCT in aggressive non-Hodgkin lymphoma had decreased overall survival outcome compared with conventional chemotherapy.

Villanueva ML, Vose JM. The role of haematopoietic stem cell transplantation in non-Hodgkin lymphoma. Clin Adv Hematol Oncol. 2006;4:521–30.PubMed

Kim SW, Tanimoto TE, Hirabayashi N, et al. Myeloablative allogeneic haematopoietic stem cell transplantation for non-Hodgkin lymphoma: a nationwide survey in Japan. Blood. 2006;108:382–9.PubMedCrossRef

Philip T, Guglielmi C, Hagenbeek A, et al. Autologous bone marrow transplantation as compared with salvage chemotherapy in relapses of chemotherapy-sensitive non-Hodgkin’s lymphoma. N Engl J Med. 1995;333(23):1540–5.PubMedCrossRef

Greb A, Bohlius J, Trelle S, et al. High-dose chemotherapy with autologous stem cell support in first-line treatment of aggressive non-Hodgkin lymphoma–Results of a comprehensive meta-analysis. Cancer Treat Rev. 2007;33:338–46.PubMedCrossRef

Peter JV, John P, Graham PL, et al. Corticosteroids in the prevention and treatment of acute respiratory distress syndrome (ARDS) in adults: meta-analysis. BMJ. 2008;336:1006–9.PubMedCrossRef

Parmar MK, Torri V, Stewart L. Extracting summary statistics to perform meta-analyses of the published literature for survival endpoints. Stat Med. 1998;17:2815–34.PubMedCrossRef

Berlin JA, Laird NM, Sacks HS, et al. A comparison of statistical methods for combining event rates from clinical trials. Stat Med. 1989;8:141–51.PubMedCrossRef

Linch D, Yung L, Smith P, et al. A randomised trial of CHOP × 6–8 vs HOP × 3 + BEAM + ASCT in 457 patients with poor prognosis histologically aggressive non-Hodgkins lymphoma. Ann Oncol. 2002;13:28.

De Souza C, Baldissera R, Simoes B, et al. Unselected High-Risk IPI NHL presented a high early mortality rate in a prospective randomized study comparing conventional chemotherapy and high-dose escalation followed by autologous bone marrow transplantation. Blood. 2001;98:391B.

10.

Rodriguez MA, van Besien K, Hagemeister FB, et al. Randomized comparison of frontline alternating chemotherapy (ATT) versus brief induction followed by autologous stem cell transplantation (ASCT) for aggressive lymphomas. Blood. 2003;102:402A.CrossRef

11.

Santini G, Olivieri A, Congiu M, et al. VACOP-B vs VACOP-B High-dose sequential therapy (HDS) for aggressive non-Hodgkin’s lymphoma (NHL). Final analysis of the NHLCSG. ASCO Annual Meeting; 2003.

12.

Milpied N, Deconinck E, Gaillard F, et al. Initial treatment of aggressive lymphoma with high-dose chemotherapy and autologous stem-cell support. N Engl J Med. 2004;350(13):1287–95.PubMedCrossRef

13.

Gianni AM, Bregni M, Siena S, et al. High-dose chemotherapy and autologous bone marrow transplantation compared with MACOP-B in aggressive B-cell lymphoma. N Engl J Med. 1997;336:1290–7.PubMedCrossRef

14.

Gisselbrecht C, Lepage E, Molina T, et al. Shortened first-line high-dose chemotherapy for patients with poor-prognosis aggressive lymphoma. J Clin Oncol. 2002;20:2472–9.PubMedCrossRef

15.

Haioun C, Lepage E, Gisselbrecht C, et al. Comparison of autologous bone marrow transplantation with sequential chemotherapy for intermediate-grade and high-grade non-Hodgkin’s lymphoma in first complete remission: a study of 464 patients. Groupe d’Etude des Lymphomes de l’Adulte. J Clin Oncol. 1994;12:2543–51.PubMed

16.

Intragumtornchai T, Prayoonwiwat W, Numbenjapon T, et al. CHOP versus CHOP plus ESHAP and high-dose therapy with autologous peripheral blood progenitor cell transplantation for high-intermediate-risk and high-risk aggressive non-Hodgkin’s lymphoma. Clin Lymphoma. 2000;1:219–25.PubMedCrossRef

17.

Kaiser U, Uebelacker I, Abel U, et al. Randomized study to evaluate the use of high-dose therapy as part of primary treatment for “aggressive” lymphoma. J Clin Oncol. 2002;20:4413–9.PubMedCrossRef

18.

Kluin-Nelemans HC, Zagonel V, Anastasopoulou A, et al. Standard chemotherapy with or without high-dose chemotherapy for aggressive non-Hodgkin’s lymphoma: randomized phase III EORTC study. J Natl Cancer Inst. 2001;93:22–30.PubMedCrossRef

19.

Martelli M, Vignetti M, Zinzani PL, et al. High-dose chemotherapy followed by autologous bone marrow transplantation versus dexamethasone, cisplatin, and cytarabine in aggressive non-Hodgkin’s lymphoma with partial response to front-line chemotherapy: a prospective randomized italian multicenter study. J Clin Oncol. 1996;14:534–42.PubMed

20.

Martelli M, Gherlinzoni F, De Renzo A, et al. Early autologous stem-cell transplantation versus conventional chemotherapy as front-line therapy in high-risk, aggressive non-Hodgkin’s lymphoma: an Italian multicenter randomized trial. J Clin Oncol. 2003;21:1255–62.PubMedCrossRef

21.

Santini G, Salvagno L, Leoni P, et al. VACOP-B versus VACOP-B plus autologous bone marrow transplantation for advanced diffuse non-Hodgkin’s lymphoma: results of a prospective randomized trial by the non-Hodgkin’s Lymphoma Cooperative Study Group. J Clin Oncol. 1998;16:2796–802.PubMed

22.

Verdonck LF, van Putten WL, Hagenbeek A, et al. Comparison of CHOP chemotherapy with autologous bone marrow transplantation for slowly responding patients with aggressive non-Hodgkin’s lymphoma. N Engl J Med. 1995;332:1045–51.PubMedCrossRef

23.

Baldissera RC, Nucci M, Vigorito AC, et al. Frontline therapy with early intensification and autologous stem cell transplantation versus conventional chemotherapy in unselected high-risk, aggressive non-Hodgkin’s lymphoma patients: a prospective randomized GEMOH report. Acta Haematol. 2006;115:15–21.PubMedCrossRef

24.

Betticher DC, Martinelli G, Radford JA, et al. Sequential high dose chemotherapy as initial treatment for aggressive sub-types of non-Hodgkin lymphoma: results of the international randomized phase III trial (MISTRAL). Ann Oncol. 2006;17:1546–52.PubMedCrossRef

25.

Olivieri A, Santini G, Patti C, et al. Upfront high-dose sequential therapy (HDS) versus VACOP-B with or without HDS in aggressive non-Hodgkin’s lymphoma: long-term results by the NHLCSG. Ann Onco. 2005;l16:1941–8.CrossRef

26.

Vitolo U, Liberati AM, Cabras MG, et al. High dose sequential chemotherapy with autologous transplantation versus dose-dense chemotherapy MegaCEOP as first line treatment in poor-prognosis diffuse large cell lymphoma: an “Intergruppo Italiano Linfomi” randomized trial. Haematologica. 2005;90:793–801.PubMed

27.

Freedman AS, Takvorian T, Neuberg D, et al. Autologous bone marrow transplantation in poor-prognosis intermediate-grade and high-grade B-cell non-Hodgkin’s lymphoma in first remission: a pilot study. J Clin Oncol. 1993;11:931–6.PubMed

28.

Nademanee A, Molina A, O’Donnell MR, et al. Results of highdose therapy and autologous bone marrow/stem cell transplantation during remission in poor-risk intermediate- and high-grade lymphoma: international index high and high-intermediate risk group. Blood. 1997;90:3844–52.PubMed

29.

Fanin R, Silvestri F, Geromin A. Autologous stem cell transplantation for aggressive non-Hodgkin’s lymphomas in first complete or partial remission: a retrospective analysis of the outcome of 52 patients according to the age-adjusted International Prognostic Index. Bone Marrow Transpl. 1998;21:263–71.CrossRef

30.

Cortelazzo S, Rossi A, Bellavita P, et al. Clinical outcome after autologous transplantation in non-Hodgkin’s lymphoma patients with high international prognostic index (IPI). Ann Oncol. 1999;10:427–32.PubMedCrossRef

31.

Strehi J, Mey U, Glasmacher A, et al. High-dose chemotherapy followed by autologous stem cell transplantation as first-line therapy in aggressive non-Hodgkin’s lymphoma: a meta-analysis. Haematologica. 2003;88:1304–15.

32.

Wheatley K. Current controversies: which patients with acute myeloid leukaemia should receive a bone marrow transplantation?–a statistician’s view. Br J Haematol. 2002;118:351–6.PubMedCrossRef

Titel: Standard chemotherapy is superior to high-dose chemotherapy with autologous stem cell transplantation on overall survival as the first-line therapy for patients with aggressive non-Hodgkin lymphoma: a meta-analysis
verfasst von: Jing Wang
Ping Zhan
Jian Ouyang
Bing Chen
Rongfu Zhou
Yonggong Yang
Publikationsdatum: 01.09.2011
Verlag: Springer US
Erschienen in: Medical Oncology / Ausgabe 3/2011
Print ISSN: 1357-0560
Elektronische ISSN: 1559-131X
DOI: https://doi.org/10.1007/s12032-010-9517-0

Springer Medizin

Standard chemotherapy is superior to high-dose chemotherapy with autologous stem cell transplantation on overall survival as the first-line therapy for patients with aggressive non-Hodgkin lymphoma: a meta-analysis

Abstract

Neu im Fachgebiet Onkologie

Erhöhte Mortalität bei postpartalem Brustkrebs

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Bessere Prognose mit links- statt rechtsseitigem Kolon-Ca.

Update Onkologie

Springer Medizin

Abstract

Bitte loggen Sie sich ein, um Zugang zu diesem Inhalt zu erhalten

Weitere Artikel der Ausgabe 3/2011

P53 gene polymorphisms and breast cancer risk in Arab women

Preoperative serum carbohydrate antigen 125 level is an independent negative prognostic marker for overall survival in colorectal cancer

Natural products and their role in cancer therapy

Clinical outcome of breast cancer patients with N3a (≥10 positive lymph nodes) disease: has it changed over years?

Alterations of telomere length in human brain tumors

Expression of phosphatase of regenerating liver-3 in squamous cell carcinoma of the cervix

Neu im Fachgebiet Onkologie

Erhöhte Mortalität bei postpartalem Brustkrebs

Hypertherme Chemotherapie bietet Chance auf Blasenerhalt

Ein Drittel der jungen Ärztinnen und Ärzte erwägt abzuwandern

Bessere Prognose mit links- statt rechtsseitigem Kolon-Ca.

Update Onkologie