Page 18 - Wondergem

Chapter 1
Wondergem) selecting all studies on therapeutic feasibility and/or efficacy including at least one adult patient with transformed B cell non Hodgkin’s lymphoma. Studies on transformed B-CLL patients (Richters’ transformation), all reviews, case reports, guidelines and studies published as abstract only were excluded. This resulted in 107 articles, 62 with a separate analysis of outcome in TFL (table 1, ref 5,35,38, 42-100). There was a complete lack of randomized clinical trials. Studies were mainly retrospective (74%). As currently R is available for the treatment of TFL we first excluded all studies in which no R was given (n=30, grey in table 1), therefore 32 studies remained. Of these there were only 11 studies in which exclusively TFL patients were included, containing 660 patients in total (mean 60 per study, range 8-172). From these 11, we were the only studygroup exclusively describing the outcome of first line treatment, being described in chapter 5. There were 2 studies only investigating patients with relapsed disease, both about allogeneic SCT.
In these heavily pretreated patient population 5 year OS was 23 and 66% (ref 95 and 91 resp.). The remaining 8 studies described a heterogeneous patient population, both newly diagnosed and relapsed patients. This precludes cross trial comparisons and specific statements on PFS and OS. The details of these studies are described below. In conclusion no RCTs are published on first line therapy in TFL, consequently information guiding first line treatment must be deduced.
*: (“Lymphoma, Non-Hodgkin”[Mesh] AND (transform*[tw])) AND
((stem cell transplantation[tw]) OR therapy[tiab] OR therapies[tiab] OR therapeut*[tiab] OR treat[tiab] OR treated[tiab] OR treatment*[tiab] OR immunotherap*[tiab] OR chemotherap*[tiab] OR ((“therapy”[Subheading]) OR (“Therapeutics”[Mesh]))) and Embase was searched using the search term: ‘b cell lymphoma’/exp OR ‘follicular lymphoma’/exp AND transform*:ab,ti AND (‘therapy’/exp OR therapy:lnk OR therap*:ab,ti OR treat*:ab,ti OR chemotherap*:ab,ti OR immunotherap*:ab,ti OR ‘stem cell transplantation’:ab,ti) NOT ([animals]/lim NOT [humans]/lim) AND [embase]/lim.
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