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      Allogeneic hematopoietic stem cell transplantation in Hodgkin lymphoma: a systematic review and meta-analysis

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          Abstract

          Allogeneic stem cell transplantation (allo-SCT) outcomes in patients with Hodgkin lymphoma (HL) remain poorly defined. We performed a meta-analysis of allo-SCT studies in HL patients. The primary endpoints were 6-month, 1-year, 2-year, and 3-year relapse-free survival (RFS) and overall survival (OS). A total of 42 reports (1,850 patients) were included. The pooled estimates (95%CI) for 6-month, 1-year, 2-year, and 3-year RFS were 77 (59–91)%, 50 (42–57)%, 37 (31–43)%, and 31 (25–37)%, respectively. The corresponding numbers for OS were 83 (75–91)%, 68 (62–74)%, 58 (52–64)%, and 50 (41–58)%, respectively. There was statistical heterogeneity among studies in all outcomes. In meta-regression, accrual initiation year in 2000 or later was associated with higher 6-month ( P = 0.012) and 1-year OS ( P = 0.046), and pre-SCT remission with higher 2-year OS ( P = 0.047) and 1-year RFS ( P = 0.016). In conclusion, outcomes of allo-SCT in HL have improved over time, with 5–10% lower non-relapse mortality and relapse rates and 15–20% higher RFS and OS in studies that initiated accrual in 2000 or later compared to earlier studies. However, there is no apparent survival plateau, demonstrating the need to improve on current allo-SCT strategies in relapsed/refractory HL.

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          Author and article information

          Journal
          8702459
          2334
          Bone Marrow Transplant
          Bone Marrow Transplant.
          Bone marrow transplantation
          0268-3369
          1476-5365
          15 October 2016
          04 January 2016
          April 2016
          01 April 2017
          : 51
          : 4
          : 521-528
          Affiliations
          [1 ]Division of Oncology, Washington University School of Medicine, St. Louis, MO
          [2 ]Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD
          Author notes
          [* ] Correspondence: Amanda F. Cashen, M.D., 660 S. Euclid Ave, Campus Box 8007, St. Louis, MO 63110, Phone: 314-454-8306, Fax: 314-454-7551, acashen@ 123456dom.wustl.edu
          Article
          PMC5092068 PMC5092068 5092068 nihpa823022
          10.1038/bmt.2015.332
          5092068
          26726948
          Categories
          Article

          transplantation, allogeneic, Hodgkin, lymphoma, outcome

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