title: High-dose chemotherapy followed by autologous stem cell transplantation for patients with relapsed or refractory Hodgkin lymphoma: a systematic review with meta-analysis.
abstract: Treatment for Hodgkin lymphoma is effective for about 85% of the patients. A gold-standard for the 15% of relapsing patients is still missing. High-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) has shown efficacy and safety for patients, but up to date no survival benefit revealed. After systematic literature search we identified three randomised controlled trials from 1663 total hits. Meta-analysis of two trials (157 patients) showed a statistically significant increase in progression-free survival (hazard ratio 0.55, 95% confidence interval 0.35-0.86) for patients treated with HDCT and ASCT compared to conventional chemotherapy, but no difference in overall survival nor increased adverse events. The third trial (241 patients) showed an statistically significant increase in infections and 5% more treatment-related mortalities following sequential HDCT plus HDCT and ASCT compared to HDCT plus ASCT, without differences in the efficacy endpoints overall survival or progression-free survival.
authors.affiliation: Cochrane Haematological Malignancies Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany. Electronic address: michaela.rancea@uk-koeln.de.
authors.forename: Michaela
authors.initials: M
authors.lastname: Rancea
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Bastian
authors.initials: B
authors.lastname: von Tresckow
authors.affiliation: Cochrane Haematological Malignancies Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Monsef
authors.affiliation: Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Engert
authors.affiliation: Cochrane Haematological Malignancies Group, Department I of Internal Medicine, University Hospital of Cologne, Cologne, Germany.
authors.forename: Nicole
authors.initials: N
authors.lastname: Skoetz
mesh_terms: D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006689:Hodgkin Disease / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D016032:Randomized Controlled Trials as Topic; D014182:Transplantation, Autologous; D016896:Treatment Outcome
keywords: Hodgkin lymphoma; Meta-analysis; Relapse; Treatment