On the 4th of July of 2018, the Institute for Quality and Efficiency in Health Care (IQWiG) has published a final report regarding allogeneic stem cell transplantation (ASCT) in aggressive B-cell non-Hodgkin's lymphoma (B-NHL) and in T-cell non-Hodgkin's lymphoma (T-NHL). The following aims were outlined in the scope of this report:
- The benefit assessment of ASCT in adults with aggressive B-cell lymphoma (excluding primary CNS lymphomas) with:
- progression or relapse after high-dose chemotherapy and ASCT in comparison to patients treated without curative intent (B-NHL/post-auto-SCT);
- absence of progression or relapse after therapy without stem cell transplantation compared to a high dose chemotherapy and ASCT (B-NHL/naïve SCT);
- The benefit assessment of ASCT as a first-line therapy in adults with T-cell lymphoma (except cutaneous T-cell lymphomas) and the need for systemic drug therapy in comparison to systemic drug therapy alone or in combination with high-dose chemotherapy and ASCT (T-NHL/first line);
- The benefit assessment of ASCT as a first-line therapy in adults with T-cell lymphoma (except cutaneous T-cell lymphomas) with progression or relapse after systemic drug therapy compared to patients treated without curative intent (T-NHL/high-grade).
The following conclusions were provided:
- Overall, the benefit of allogeneic stem cell transplantation in B-NHL and T-NHL is unclear, as no meaningful studies are available;
- Allogeneic stem cell transplantation is currently associated with the risk of graft-versus-host disease, so the potential risks and benefits of the allogeneic stem cell transplantation should be considered before its use;
- No studies have assessed a quality of life of the patients.
See full details in German here.
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