Treatment of aggressive B-cell non-Hodgkin lymphoma beyond frontline therapy in patients not eligible for stem cell transplantation: a structured review.

Abstract

Aggressive B-cell non-Hodgkin lymphoma (aNHL) accounts for ∼50% of all NHL cases. The only potentially curative, broadly available treatment for patients with relapse, failing frontline treatment, is high-dose therapy followed by autologous stem cell transplantation (ASCT); patients ineligible for/who have failed ASCT have limited standard-of-care options. We conducted a structured review of treatments for relapsed/refractory patients with aNHL based on literature published between 2006 and 2017. Of the 22 publications identified for inclusion, most described phase II, single-arm trials (N = 25-217), and only three were randomized studies (phase II [N = 96], phase II/III [N = 111] and phase III [N = 338]). The majority of treatments evaluated resulted in only modest efficacy (median progression-free survival, 2.1-20.0 months) and ultimately poor health outcomes (median overall survival, 25 weeks-15.5 months). In conclusion, there is an unmet need for novel, effective, and tolerable treatments for patients with relapsed/refractory aNHL who are ineligible for/have failed ASCT.

• Authors: Gilles A Salles, Ruth Pettengell, Raul Cordoba, Monika Długosz-Danecka, Wojciech Jurczak, Hervé Tilly
• Journal: Leukemia & lymphoma (Leuk Lymphoma) Vol. 60 Issue 7 Pg. 1610-1625 (07 2019) ISSN: 1029-2403 [Electronic] United States
• PMID: 30702000 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't, Review)

Topics

• Combined Modality Therapy
• Disease Management
• Humans
• Lymphoma, B-Cell (pathology, therapy)
• Neoplasm Recurrence, Local (pathology, therapy)
• Prognosis
• Salvage Therapy
• Stem Cell Transplantation