High-dose chemotherapy combined with autologous stem cell transplantation (ASCT) did not improve overall survival in previously untreated adult patients with follicular lymphoma, indicated a review of seven randomized clinical trials.

A number of chemotherapy regimens have been combined with ASCT to treat persons with follicular lymphoma, the most common subtype of non-Hodgkin lymphoma in North America, according to a statement from the Journal of the National Cancer Institute, in which the current report was published. However, the impact of high-dose chemotherapy and ASCT vs conventional-dose chemotherapy in the initial management of adults with advanced follicular lymphoma on overall survival remains uncertain, noted investigators Murtadha Al Khabori of the division of medical oncology and hematology at the Princess Margaret Hospital in Toronto, Ontario, Canada, and colleagues. To address this issue, they performed a systematic review and meta-analysis of relevant randomized clinical trials.

Three of the seven studies showed moderate-quality evidence that high-dose chemotherapy with ASCT did not improve overall survival of the patients, and the remaining four trials highlighted low-quality evidence showing improvement in event-free survival for patients who received chemotherapy with ASCT. Absolute mortality risk from treatment and adverse events was similar between the two treatment groups.

Al Khabori’s team concluded that more trials of ASCT in the context of current chemoimmunotherapy approaches to follicular lymphoma are needed.