TY - JOUR
T1 - Role of Maintenance Therapy after High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation in Aggressive Lymphomas
T2 - A Systematic Review
AU - Taverna, Josephine A.
AU - Yun, Seongseok
AU - Jonnadula, Jayasree
AU - Saleh, Ahlam
AU - Riaz, Irbaz Bin
AU - Abraham, Ivo
AU - Yeager, Andrew M.
AU - Persky, Daniel O.
AU - McBride, Ali
AU - Haldar, Subrata
AU - Anwer, Faiz
N1 - Funding Information:
Financial disclosure statement: This work was supported by grants R25CA078447 (J.A.T.) and P30 CA023074 from the National Cancer Institute , National Institutes of Health , Bethesda, MD, and by a Bressler Alpert Society Research Grant from the University of Arizona (S.Y).
Publisher Copyright:
© 2016 American Society for Blood and Marrow Transplantation.
PY - 2016/7/1
Y1 - 2016/7/1
N2 - Significant uncertainty exists in regard to the efficacy of maintenance therapy after high-dose chemotherapy (HDC) as well as autologous stem cell transplantation (ASCT) for the treatment of patients with aggressive lymphoma. A systematic review was performed to evaluate the effectiveness of post-ASCT maintenance therapy in patients with relapsed/refractory lymphoma. A comprehensive literature search yielded 4476 studies and a total of 42 studies (11 randomized controlled trials [RCT], 9 retrospective comparative studies, and 22 single-arm studies) were included in the systematic review. There was significant heterogeneity in study design, chemotherapeutic regimens, post-ASCT maintenance strategies, patient enrollment criteria, and study endpoints. Our findings suggest that post-ASCT maintenance immune-targeting strategies, including PD-1/PD-L1 blocking antibodies, rituximab, and brentuximab, may improve progression-free survival but not overall survival. Collectively, the results indicate a need for testing new strategies with well-designed and adequately powered RCTs to better address the role of post-ASCT maintenance in relapsed/refractory lymphomas.
AB - Significant uncertainty exists in regard to the efficacy of maintenance therapy after high-dose chemotherapy (HDC) as well as autologous stem cell transplantation (ASCT) for the treatment of patients with aggressive lymphoma. A systematic review was performed to evaluate the effectiveness of post-ASCT maintenance therapy in patients with relapsed/refractory lymphoma. A comprehensive literature search yielded 4476 studies and a total of 42 studies (11 randomized controlled trials [RCT], 9 retrospective comparative studies, and 22 single-arm studies) were included in the systematic review. There was significant heterogeneity in study design, chemotherapeutic regimens, post-ASCT maintenance strategies, patient enrollment criteria, and study endpoints. Our findings suggest that post-ASCT maintenance immune-targeting strategies, including PD-1/PD-L1 blocking antibodies, rituximab, and brentuximab, may improve progression-free survival but not overall survival. Collectively, the results indicate a need for testing new strategies with well-designed and adequately powered RCTs to better address the role of post-ASCT maintenance in relapsed/refractory lymphomas.
KW - Autologous hematopoietic stem cell transplantation
KW - Hodgkin disease
KW - Maintenance therapy
KW - Non-Hodgkin lymphoma
KW - Relapse
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U2 - 10.1016/j.bbmt.2016.02.007
DO - 10.1016/j.bbmt.2016.02.007
M3 - Article
C2 - 26899562
AN - SCOPUS:84975317346
SN - 1083-8791
VL - 22
SP - 1182
EP - 1196
JO - Biology of Blood and Marrow Transplantation
JF - Biology of Blood and Marrow Transplantation
IS - 7
ER -