Stem Cell Transplantation Superior to Chemotherapy for Relapsed/Refractory DLBCL, Follicular Lymphoma

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SCT and chemotherapy/immunotherapy are common treatment for diffuse large B-cell lymphoma and follicular lymphoma.
SCT and chemotherapy/immunotherapy are common treatment for diffuse large B-cell lymphoma and follicular lymphoma.

Stem cell transplant therapy may be a better treatment option than chemotherapy for patients with relapsed/refractory diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma (FL), according to a large scale systematic literature review evaluating real world therapy outcomes, published in Future Science OA.

Diffuse large B-cell lymphoma and follicular lymphoma account for two-thirds of all non-Hodgkin lymphomas and are associated with a high likelihood of disease relapse. Stem cell transplantation and chemotherapy/immunotherapy are the commonly recommended courses of treatment, but until now, there has not been an evaluation of the real world outcomes of these therapies to determine which is most beneficial. 

In the recent meta-analysis, the authors reviewed 33 articles identified on Medline/Embase pertaining to DLBCL/FL therapies, including stem cell transplant, chemotherapy, and experimental regimes. Patients that underwent stem cell therapy had the highest overall survival rates, an unsurprising result as stem cell transplant is often considered the optimal strategy following relapse. 

However, not all patients are illegible for stem cell therapy due to age, or comorbidity. In such patients, treatment with rituximab is recommended. However, rituximab-based treatments had a lower prognosis of survival and were overall inferior to stem cell transplant. “A lack of viable treatment options for DLBCL/FL patients ineligible for [stem cell transplant] after relapse remains a significant gap in care,” noted the authors.

Reference

Galaznik A, Huelin R, Stokes M, et al.Systematic review of therapy used in relapsed or refractory diffuse large B-cell lymphoma and follicular lymphoma.Future Sci OA.2018;4(7):FSO322.

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