The effectiveness and reliability of autologous hematopoietic stem cell transplantation following chemotherapy in managing malignant lymphoma: a meta-analysis.

in Discover oncology by Hend Ahmed, Ahmed S Shafiey, Mohamed E A Abdelrahim

TLDR

  • AHSCT treatment is associated with improved overall survival and progression-free survival rates in patients with malignant lymphoma compared to standard chemotherapy.

Abstract

Autologous hematopoietic stem cell transplantation (AHSCT) is a valuable treatment option for several hematological malignancies, particularly in relapsed or refractory cases. Autologous hematopoietic stem cell transplantation (AHSCT) is effective in improving survival rates in selected patients, particularly those with aggressive lymphomas and multiple myeloma. Studies suggest AHSCT may outperform alternative therapies, but ongoing research is essential to refine patient selection. Many patients enjoy prolonged remission and improved quality of life, indicating the need for long-term follow-up to assess late effects and overall survival. This work aimed to establish meta-analysis to methodically evaluate the safety and effectiveness of autologous stem cell therapy (AHSCT) in the management of malignant lymphoma following high-dose chemotherapy and to produce reliable findings that may serve as a foundation for clinical application and reference. A systematic literature search was performed from February 2017 to August 2024, and malignant lymphoma was identified as the study subjects' diagnosis. The experimental group was identified as AHSCT afterwards high-dose chemotherapy, while the control group underwent standard chemotherapy (with no restrictions on the chemotherapy regimen). The outcome indicators were progression-free survival (PFS), complete remission rate (complete response (CR) + partial response (PR)), and overall survival (OS). Fifteen literature pieces in all, consisting of 1229 subjects in the control group and 896 subjects in the experimental group, were included. Conventional chemotherapy (chemotherapy regimen not limited) was the intervention strategy used in the control group. The odds ratio (OR) was 2.23, with a 95% confidence interval (CI) of [1.54, 3.22], Z = 4.25; P < 0.0001, indicating that the groups differed in overall survival and progression-free survival rates. Similarly, the progression-free survival rate was 2.70, with a 95% CI of 1.86-3.92, Z = 4.25; P < 0.0001, and overall survival was 2.23. Patients with malignant lymphoma who receive chemotherapy can substantially extend their overall survival and progression-free survival rates with AHSCT treatment.

Overview

  • The study aimed to investigate the safety and effectiveness of autologous stem cell therapy (AHSCT) in the management of malignant lymphoma following high-dose chemotherapy.
  • A systematic literature search was conducted to identify relevant studies, and the outcome indicators were progression-free survival (PFS), complete remission rate, and overall survival (OS).
  • The study found that patients with malignant lymphoma who received AHSCT treatment had significantly improved overall survival and progression-free survival rates compared to those who received standard chemotherapy.

Comparative Analysis & Findings

  • The results showed that the experimental group (AHSCT) had a significantly higher overall survival rate (95% CI [1.54, 3.22], Z = 4.25; P < 0.0001) and progression-free survival rate (95% CI [1.86-3.92], Z = 4.25; P < 0.0001) compared to the control group (standard chemotherapy).
  • The odds ratio (OR) was 2.23, indicating that AHSCT treatment was associated with a significantly improved overall survival rate.
  • The study found that AHSCT treatment led to a 2.70-fold increase in the progression-free survival rate compared to standard chemotherapy.

Implications and Future Directions

  • The study's findings suggest that AHSCT treatment can be a valuable option for patients with malignant lymphoma who have relapsed or are refractory to standard chemotherapy.
  • future studies should aim to identify predictors of response to AHSCT treatment and to refine patient selection criteria.
  • Long-term follow-up is essential to assess late effects and overall survival in patients who receive AHSCT treatment.
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