Cargando…
Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis
This study aimed to compare the efficacy of allogeneic stem cell transplantation (allo-SCT) versus autologous SCT (auto-SCT) in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Medline, CENTRAL, and EMBASE databases through December 31, 2019 were searched. The primary endpoi...
Autores principales: | , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
SAGE Publications
2020
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784574/ https://www.ncbi.nlm.nih.gov/pubmed/33238731 http://dx.doi.org/10.1177/0963689720975397 |
_version_ | 1783632317547282432 |
---|---|
author | Wang, Jianhong Duan, Xiaohui Yang, Lijie Liu, Xiangxiang Hao, Caixia Dong, Hongjuan Gu, Hongtao Tang, Hailong Dong, Baoxia Zhang, Tao Gao, Guangxun Liang, Rong |
author_facet | Wang, Jianhong Duan, Xiaohui Yang, Lijie Liu, Xiangxiang Hao, Caixia Dong, Hongjuan Gu, Hongtao Tang, Hailong Dong, Baoxia Zhang, Tao Gao, Guangxun Liang, Rong |
author_sort | Wang, Jianhong |
collection | PubMed |
description | This study aimed to compare the efficacy of allogeneic stem cell transplantation (allo-SCT) versus autologous SCT (auto-SCT) in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Medline, CENTRAL, and EMBASE databases through December 31, 2019 were searched. The primary endpoints were overall survival (OS) and progression-free survival (PFS) rates. The secondary outcomes include transplant-related mortality (TRM), event-free survival, relapse/or progression, and nonrelapse mortality (NRM). The 18 retrospective studies enrolled 8,058 B-NHL patients (allo-SCT = 1,204; auto-SCT = 6,854). The OS was significantly higher in patients receiving auto-SCT than allo-SCT (pooled odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.29 to 2.22, P < 0.001), but no significant difference was found in PFS (pooled OR: 0.98, 95% CI: 0.69 to 1.38, P = 0.891). Auto-SCT patients also had lower TRM and NRM (TRM: OR = 0.23, P < 0.001; NRM: OR = 0.16, P < 0.001), but higher relapse or progression rate (OR = 2.37, P < 0.001) than allo-SCT patients. Subgroup analysis performed for different grades and subtypes of B-NHL showed higher OS in auto-SCT patients with high-grade B-NHL and diffused large B-cell lymphoma (DLBCL). There was, nevertheless, higher PFS in allo-SCT patients with low-grade B-NHL and follicular lymphoma (FL), and lower PFS in allo-SCT patients with DLBCL than their auto-SCT counterparts. In conclusion, the meta-analysis demonstrated that relapsed or refractory B-NHL patients who received auto-SCT have improved OS than those treated with allo-SCT, especially among those with DLBCL, but lower PFS among those with FL. However, the study is limited by a lack of randomized trials, patients’ heterogeneity, and possible selection bias. |
format | Online Article Text |
id | pubmed-7784574 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | SAGE Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-77845742021-01-14 Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis Wang, Jianhong Duan, Xiaohui Yang, Lijie Liu, Xiangxiang Hao, Caixia Dong, Hongjuan Gu, Hongtao Tang, Hailong Dong, Baoxia Zhang, Tao Gao, Guangxun Liang, Rong Cell Transplant Original Article This study aimed to compare the efficacy of allogeneic stem cell transplantation (allo-SCT) versus autologous SCT (auto-SCT) in patients with relapsed or refractory B-cell non-Hodgkin lymphoma (B-NHL). Medline, CENTRAL, and EMBASE databases through December 31, 2019 were searched. The primary endpoints were overall survival (OS) and progression-free survival (PFS) rates. The secondary outcomes include transplant-related mortality (TRM), event-free survival, relapse/or progression, and nonrelapse mortality (NRM). The 18 retrospective studies enrolled 8,058 B-NHL patients (allo-SCT = 1,204; auto-SCT = 6,854). The OS was significantly higher in patients receiving auto-SCT than allo-SCT (pooled odds ratio [OR]: 1.69, 95% confidence interval [CI]: 1.29 to 2.22, P < 0.001), but no significant difference was found in PFS (pooled OR: 0.98, 95% CI: 0.69 to 1.38, P = 0.891). Auto-SCT patients also had lower TRM and NRM (TRM: OR = 0.23, P < 0.001; NRM: OR = 0.16, P < 0.001), but higher relapse or progression rate (OR = 2.37, P < 0.001) than allo-SCT patients. Subgroup analysis performed for different grades and subtypes of B-NHL showed higher OS in auto-SCT patients with high-grade B-NHL and diffused large B-cell lymphoma (DLBCL). There was, nevertheless, higher PFS in allo-SCT patients with low-grade B-NHL and follicular lymphoma (FL), and lower PFS in allo-SCT patients with DLBCL than their auto-SCT counterparts. In conclusion, the meta-analysis demonstrated that relapsed or refractory B-NHL patients who received auto-SCT have improved OS than those treated with allo-SCT, especially among those with DLBCL, but lower PFS among those with FL. However, the study is limited by a lack of randomized trials, patients’ heterogeneity, and possible selection bias. SAGE Publications 2020-11-26 /pmc/articles/PMC7784574/ /pubmed/33238731 http://dx.doi.org/10.1177/0963689720975397 Text en © The Author(s) 2020 https://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access pages (https://us.sagepub.com/en-us/nam/open-access-at-sage). |
spellingShingle | Original Article Wang, Jianhong Duan, Xiaohui Yang, Lijie Liu, Xiangxiang Hao, Caixia Dong, Hongjuan Gu, Hongtao Tang, Hailong Dong, Baoxia Zhang, Tao Gao, Guangxun Liang, Rong Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis |
title | Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis |
title_full | Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis |
title_fullStr | Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis |
title_full_unstemmed | Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis |
title_short | Comparison of Survival Between Autologous and Allogeneic Stem Cell Transplantation in Patients with Relapsed or Refractory B-Cell Non-Hodgkin Lymphoma: A Meta-Analysis |
title_sort | comparison of survival between autologous and allogeneic stem cell transplantation in patients with relapsed or refractory b-cell non-hodgkin lymphoma: a meta-analysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7784574/ https://www.ncbi.nlm.nih.gov/pubmed/33238731 http://dx.doi.org/10.1177/0963689720975397 |
work_keys_str_mv | AT wangjianhong comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT duanxiaohui comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT yanglijie comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT liuxiangxiang comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT haocaixia comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT donghongjuan comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT guhongtao comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT tanghailong comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT dongbaoxia comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT zhangtao comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT gaoguangxun comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis AT liangrong comparisonofsurvivalbetweenautologousandallogeneicstemcelltransplantationinpatientswithrelapsedorrefractorybcellnonhodgkinlymphomaametaanalysis |