EFFICACY OF AUTOLOGOUS STEM CELL TRANSPLANTATION IN ADULT BURKITT/BURKITT-LIKE LYMPHOMA: A SYSTEMATIC REVIEW.

Q3 Medicine Experimental oncology Pub Date : 2022-11-01 DOI:10.32471/exp-oncology.2312-8852.vol-44-no-3.18599

U Joshi, R Subedi, G Nepal, S Gyawali, V Agrawal, B S Poudyal, V R Bhatt, Ch R D'Angelo

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Abstract

Background: Burkitt and Burkitt like lymphoma (BL/BLL) are highly proliferative germinal or post-germinal B cell tumors. Few studies have evaluated the impact of autologous stem cell transplantation (ASCT) on disease outcomes.

Aim: We performed a systematic review to analyze the efficacy of ASCT as frontline consolidation and for treatment of relapsed/refractory cases in adult BL/BLL.

Materials and methods: Eligible studies with clear outcome measures on the efficacy of ASCT in adult patients with BL/BLL were identified through systematic search. The overall survival (OS), progression-free survival (PFS), complete response (CR), partial response (PR), and progression/relapse were used to assess the efficacy.

Results: For patients who underwent ASCT in first CR, 5-year PFS and OS ranged between 70-78% and 70-83% respectively. For relapsed/refractory disease, 5-year PFS and OS were 27% and 31%, respectively. Patients undergoing ASCT for chemoresistant disease fared poorly with 3-year OS of 7% vs 37% for chemosensitive disease (p ≤ 0.00001). The overall response rate to ASCT for patients transplanted in first CR ranged between 71% and 93% and was 37% for patients who were transplanted in disease status other than first CR. Disease progression/relapse was observed in 16-29% of the patients transplanted in first CR, and 55% to 60% in relapsed disease.

Conclusion: We found insufficient evidence to support ASCT over chemotherapy alone in the first remission for adult BL/BLL. Evidence supports guidelines recommending ASCT for chemosensitive disease but suggests there is no benefit to ASCT for chemoresistant disease.

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自体干细胞移植对成人伯基特/伯基特样淋巴瘤的疗效：系统综述。

背景：伯基特淋巴瘤和类伯基特淋巴瘤（BL/BLL）是高度增殖的生殖性或后生殖性B细胞肿瘤。目的：我们进行了一项系统综述，分析自体干细胞移植作为前线巩固治疗以及治疗成人BL/BLL复发/难治病例的疗效：通过系统检索，确定了对成人BL/BLL患者ASCT疗效有明确结果测量的合格研究。采用总生存期（OS）、无进展生存期（PFS）、完全应答（CR）、部分应答（PR）和进展/复发来评估疗效：首次CR接受ASCT治疗的患者，5年PFS和OS分别为70%-78%和70%-83%。对于复发/难治性疾病，5年PFS和OS分别为27%和31%。因化疗耐药而接受ASCT治疗的患者情况较差，3年OS为7%，而化疗敏感性疾病为37%（P≤0.00001）。首次CR移植患者的ASCT总反应率介于71%和93%之间，首次CR以外疾病状态移植患者的总反应率为37%。在首次CR的移植患者中，16%-29%的患者出现疾病进展/复发，而在复发的患者中，55%-60%的患者出现疾病进展/复发：我们发现，没有足够的证据支持在成人 BL/BLL 首次缓解期进行 ASCT 而非单纯化疗。有证据支持指南推荐对化疗敏感的疾病进行 ASCT，但表明 ASCT 对化疗耐药的疾病没有益处。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Experimental oncology Medicine-Oncology

CiteScore

1.40

自引率

0.00%

发文量

期刊介绍： The Experimental Oncology is an English-language journal that publishes review articles, original contributions, short communications, case reports and technical advances presenting new data in the field of experimental and fundamental oncology. Manuscripts should be written in English, contain original work, which has not been published or submitted for publication elsewhere. It also implies the transfer of the Copyright from the author to “Experimental Oncology”. No part of journal publications may be reproduced, stored in a retrieval system or transmitted in any form or by any means without the prior permission of the publisher.