Role of Maintenance Therapy after High-Dose Chemotherapy and Autologous Hematopoietic Cell Transplantation in Aggressive Lymphomas: A Systematic Review

Josephine A. Taverna, Seongseok Yun, Jayasree Jonnadula, Ahlam Saleh, Irbaz Bin Riaz, Ivo L Abraham, Andrew M Yeager, Daniel O. Persky, Ali McBride, Subrata Haldar, Faiz - Anwer

Research output: Contribution to journalArticle

7 Scopus citations

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1182-1196
Number of pages15
JournalBiology of Blood and Marrow Transplantation
Volume22
Issue number7
DOIs
StatePublished - Jul 1 2016

Keywords

  • Autologous hematopoietic stem cell transplantation
  • Hodgkin disease
  • Maintenance therapy
  • Non-Hodgkin lymphoma
  • Relapse

ASJC Scopus subject areas

  • Hematology
  • Transplantation

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