Efficacy of Autologous Stem Cell Transplantation in Adult Burkitt/Burkitt-Like Lymphoma: A Systematic Review

Authors

Utsav Joshi, Rochester Regional HealthFollow
Roshan Subedi, Rochester Regional HealthFollow
G Nepal, Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal.
S Gyawali, Department of Internal Medicine, Sukraraj Tropical and Infectious Disease Hospital, Kathmandu 44600, Nepal.
V Agrawal, Department of Internal Medicine, Tribhuvan University Teaching Hospital, Institute of Medicine, Kathmandu 44600, Nepal.
B S. Poudyal, Clinical Hematology and Bone Marrow Transplant Unit, Civil Service Hospital, Kathmandu 44600, Nepal.
V R. Bhatt, Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA.
Ch R. D'Angelo, Department of Internal Medicine, Division of Hematology-Oncology, University of Nebraska Medical Center, Omaha, NE 68198, USA.

Department

Internal Medicine

Document Type

Article

Publication Title

Experimental Oncology

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.

First Page

190

Last Page

197

DOI

10.32471/exp-oncology.2312-8852.vol-44-no-3.18599

Volume

44

Issue

3

Publication Date

11-1-2022

Medical Subject Headings

Adult; Humans; Transplantation, Autologous; Hematopoietic Stem Cell Transplantation (adverse effects); Antineoplastic Combined Chemotherapy Protocols (therapeutic use); Neoplasm Recurrence, Local (therapy); Burkitt Lymphoma (therapy); Retrospective Studies; Disease-Free Survival

PubMed ID

36325697

Recommended Citation

Joshi, U., Subedi, R., Nepal, G., Gyawali, S., Agrawal, V., Poudyal, B. S., Bhatt, V. R., & D'Angelo, C. R. (2022). Efficacy of Autologous Stem Cell Transplantation in Adult Burkitt/Burkitt-Like Lymphoma: A Systematic Review. Experimental Oncology, 44 (3), 190-197. https://doi.org/10.32471/exp-oncology.2312-8852.vol-44-no-3.18599