Dados do Resumo

Título

Global survival of Hodgkin's lymphoma after autologous hematopoietic stem cell transplantation: a systematic review with meta-analysis

Introdução

It's still unclear how Hodgkin's lymphoma patients would fare following hematopoietic stem cell transplantation (HSCT). It is crucial to stress that a clear prognosis is necessary for better understanding the disease and its progression, as well as for a suitable selection of patients who are submitted for autologous HSCT.

Objetivo

To systematically review the literature on the prognosis of patients diagnosed with Hodgkin's Lymphoma who underwent autologous hematopoietic stem cell transplantation and to assess overall 10-year post-transplant survival.

Métodos

We conducted a meta-analysis and systematic review of the cohort studies. We searched the databases of PubMed, EMBASE, and Virtual Health Library to find relevant studies. Included were cohort studies that solely assessed the prognosis of Hodgkin's lymphoma patients receiving autologous stem cell transplantation (HSCT). There were no restrictions on the year or language of publication; all research were conducted on human subjects. Two impartial reviewers evaluated the Altman criteria while choosing the studies, assessing their quality, and extracting the data. Using a random effect model, we calculated the 95% confidence interval (CI). The heterogeneity of the studies was evaluated using the Chi² test, with a significance level set at P <0,05. We also quantified potential heterogeneities using the I² statistic, realized the funnelplot graph, and evaluated the significance of each study using the sensitivity test. Before the start of data collection, the project was registered in the prospective international registry base of systematic reviews (PROSPERO)

Resultados

The review contained 2,335 persons' worth of data from 20 cohort studies. The duration of the follow-up was 34–216 months. Nodular sclerosis was the most common histological form of Hodgkin's lymphoma. Patients showed between stages III and IV of the disease at the time of diagnosis in 95% of the investigations. Overall survival was 57% (95% CI 44.7% to 69.9%), 56.9% (95% CI 50.1% to 63.6%), and 44.9% (95% CI 33.3% to 56.5%) at 3, 5, and 10 years, respectively. These results indicate that patients undergoing hematopoietic stem cell transplantation tend to have lower survival rates over time. Following hematopoietic stem cell transplantation, disease progression was the leading cause of mortality. Post-transplant toxicity, sepsis, the development of a second hematological malignancy, lung illness, hemorrhagic events, and suicide were the next most common causes.

Conclusões

For patients with Hodgkin's lymphoma who were diagnosed in stages III–IV of the disease following a first relapse, hematopoietic stem cell transplantation (HSCT) is a therapeutic option with encouraging outcomes. The overall survival of patients following HSCT gradually declines at 3, 5, and 10 years.

Financiador do resumo

Sem fonte financiadora para realização do estudo

Palavras Chave

Hodgkin disease; prognoses; autologous transplantation