Universität zu Köln

Eichenauer, Dennis A., Becker, Ingrid ORCID: 0000-0001-5829-3553, Monsef, Ina, Chadwick, Nicholas, de Sanctis, Vitaliana, Federico, Massimo, Fortpied, Catherine, Gianni, Alessandro M., Henry-Amar, Michel ORCID: 0000-0002-9357-6476, Hoskin, Peter ORCID: 0000-0001-8323-9567, Johnson, Peter ORCID: 0000-0003-2306-4974, Luminari, Stefano ORCID: 0000-0001-8446-2285, Bellei, Monica ORCID: 0000-0001-7846-732X, Pulsoni, Alessandro, Sydes, Matthew R., Valagussa, Pinuccia, Viviani, Simonetta ORCID: 0000-0002-5014-9546, Engert, Andreas and Franklin, Jeremy ORCID: 0000-0003-1536-0925 (2017). Secondary malignant neoplasms, progression-free survival and overall survival in patients treated for Hodgkin lymphoma: a systematic review and meta-analysis of randomized clinical trials. Haematologica, 102 (10). S. 1748 - 1758. PAVIA: FERRATA STORTI FOUNDATION. ISSN 0390-6078

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Abstract

Treatment intensification to maximize disease control and reduced intensity approaches to minimize the risk of late sequelae have been evaluated in newly diagnosed Hodgkin lymphoma. The influence of these interventions on the risk of secondary malignant neoplasms, progression-free survival and overall survival is reported in the meta-analysis herein, based on individual patient data from 9498 patients treated within 16 randomized controlled trials for newly diagnosed Hodgkin lymphoma between 1984 and 2007. Secondary malignant neoplasms were meta-analyzed using Peto's method as time-to-event outcomes. For progression-free and overall survival, hazard ratios derived from each trial using Cox regression were combined by inverse-variance weighting. Five study questions (combined-modality treatment vs. chemotherapy alone; more extended vs. involved-field radiotherapy; radiation at higher doses vs. radiation at 20 Gy; more vs. fewer cycles of the same chemotherapy protocol; standard-dose chemotherapy vs. intensified chemotherapy) were investigated. After a median follow-up of 7.4 years, dose-intensified chemotherapy resulted in better progression-free survival rates (P=0.007) as compared with standard-dose chemotherapy, but was associated with an increased risk of therapy-related acute myeloid leukemia/myelodysplastic syndromes (P=0.0028). No progression-free or overall survival differences were observed between combined-modality treatment and chemotherapy alone, but more secondary malignant neoplasms were seen after combined-modality treatment (P=0.010). For the remaining three study questions, outcomes and secondary malignancy rates did not differ significantly between treatment strategies. The results of this meta-analysis help to weigh up efficacy and secondary malignancy risk for the choice of first-line treatment for Hodgkin lymphoma patients. However, final conclusions regarding secondary solid tumors require longer follow-up.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Eichenauer, Dennis A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Becker, Ingrid UNSPECIFIED orcid.org/0000-0001-5829-3553 UNSPECIFIED Monsef, Ina UNSPECIFIED UNSPECIFIED UNSPECIFIED Chadwick, Nicholas UNSPECIFIED UNSPECIFIED UNSPECIFIED de Sanctis, Vitaliana UNSPECIFIED UNSPECIFIED UNSPECIFIED Federico, Massimo UNSPECIFIED UNSPECIFIED UNSPECIFIED Fortpied, Catherine UNSPECIFIED UNSPECIFIED UNSPECIFIED Gianni, Alessandro M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Henry-Amar, Michel UNSPECIFIED orcid.org/0000-0002-9357-6476 UNSPECIFIED Hoskin, Peter UNSPECIFIED orcid.org/0000-0001-8323-9567 UNSPECIFIED Johnson, Peter UNSPECIFIED orcid.org/0000-0003-2306-4974 UNSPECIFIED Luminari, Stefano UNSPECIFIED orcid.org/0000-0001-8446-2285 UNSPECIFIED Bellei, Monica UNSPECIFIED orcid.org/0000-0001-7846-732X UNSPECIFIED Pulsoni, Alessandro UNSPECIFIED UNSPECIFIED UNSPECIFIED Sydes, Matthew R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Valagussa, Pinuccia UNSPECIFIED UNSPECIFIED UNSPECIFIED Viviani, Simonetta UNSPECIFIED orcid.org/0000-0002-5014-9546 UNSPECIFIED Engert, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Franklin, Jeremy UNSPECIFIED orcid.org/0000-0003-1536-0925 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-216614
DOI:	10.3324/haematol.2017.167478
Journal or Publication Title:	Haematologica
Volume:	102
Number:	10
Page Range:	S. 1748 - 1758
Date:	2017
Publisher:	FERRATA STORTI FOUNDATION
Place of Publication:	PAVIA
ISSN:	0390-6078
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language INVOLVED-FIELD RADIOTHERAPY; REQUIRING PROLONGED OBSERVATION; 2ND CANCER-RISK; STANFORD-V; INTENSIFIED CHEMOTHERAPY; BRENTUXIMAB VEDOTIN; INTERMEDIATE-STAGE; COMPLETE REMISSION; ADAPTED TREATMENT; COMBINED-MODALITY Multiple languages Hematology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/21661