Hodgkin's lymphoma (relapsed or refractory): autologous stem cell therapy.

Abstract

Introduction: People with Hodgkin's lymphoma usually present with a lump in the neck or upper chest, but a quarter of people also have fever, sweating, weight loss, fatigue, and itch. Almost all people with localised disease can be cured and, even among people with relapsed advanced disease, almost 50% to 60% survive event-free for 4 years or more. However, a proportion of patients with early Hodgkin's lymphoma with poor prognostic factors (up to 15%) or with advanced disease (40%-50%) still relapses or has refractory disease.

Methods and outcomes: We conducted a systematic overview, aiming to answer the following clinical question: What are the effects of high-dose chemotherapy plus autologous stem cell therapy for relapsed or refractory Hodgkin's lymphoma? We searched: Medline, Embase, The Cochrane Library, and other important databases up to September 2014 (Clinical Evidence overviews are updated periodically; please check our website for the most up-to-date version of this overview).

Results: Searching of electronic databases retrieved 298 studies. Appraisal of titles and abstracts led to the exclusion of 245 studies and the further review of 53 full publications. Of the 53 full articles evaluated, one systematic review was added. We performed a GRADE evaluation for three PICO combinations.

Conclusions: In this systematic overview, we categorised the efficacy for one intervention, based on information relating to the effectiveness and safety of high-dose chemotherapy plus autologous stem cell therapy (versus conventional chemotherapy).