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. 2011:2011:623924.
doi: 10.5402/2011/623924. Epub 2011 Jun 16.

A Systematic Review and Meta-Analysis of Front-line Anthracycline-Based Chemotherapy Regimens for Peripheral T-Cell Lymphoma

Abeer N Abouyabis  1 , Pareen J Shenoy, Rajni Sinha, Christopher R Flowers, Mary Jo Lechowicz
Affiliations

A Systematic Review and Meta-Analysis of Front-line Anthracycline-Based Chemotherapy Regimens for Peripheral T-Cell Lymphoma

Abeer N Abouyabis et al. ISRN Hematol. 2011.

Abstract

Anthracycline-based chemotherapy remains standard treatment for peripheral T-cell lymphoma (PTCL) although its benefits have been questioned. We performed systematic literature review and meta-analyses examining the complete response (CR) and overall survival (OS) rates for patients with PTCL. The CR rate for PTCL patients ranged from 35.9% (95% CI 23.4-50.7%) for enteropathy-type T-cell lymphoma (ETTL) to 65.8% (95% CI 54.0-75.9%) for anaplastic large cell lymphoma (ALCL). The 5-year OS was 38.5% (95% CI 35.5-41.6%) for all PTCL patients and ranged from 20.3% (95% CI 12.5-31.2%) for ETTL to 56.5% (95% CI 42.8-69.2%) for ALCL. These data suggest that there is marked heterogeneity across PTCL subtypes in the benefits of anthracycline-based chemotherapy. While anthracyclines produce CR in half of PTCL patients, this yields reasonable 5-year OS for patients with ALCL but not for those with PTCL-NOS or ETTL. Novel agents and regimens are needed to improve outcomes for these patients.

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Figures

Figure 1
Figure 1
Quorum flow chart of study inclusion. Illustration of the number of articles identified in literature search and reasons for exclusion. Thirty studies met the inclusion and exclusion criteria.
Figure 2
Figure 2
Meta-analysis of complete response rate of patients undergoing anthracycline-based chemotherapy by PTCL subtype. Forest plot of the complete response rate along with summary estimates and its 95% CI in diamonds. Horizontal lines show the 95% CI for each trial. Only subtypes showing no evidence of heterogeneity were grouped. Within each subtypes, studies were ordered by year of reporting and alphabetical order. Squares on the plot are proportional to the weight of each study. Fixed effect and random effects models summary estimates are depicted in boldface.
Figure 3
Figure 3
Funnel plot of standard error by logit complete response rate. The funnel plot of studies included in the meta-analysis of complete response rate illustrates the standard error and logit of complete response rate.
Figure 4
Figure 4
Meta-analysis of 5-year overall survival rate of patients undergoing anthracycline-based chemotherapy by PTCL subtype. Forest plot of the complete response rate along with summary estimates and its 95% CI in diamonds. Horizontal lines show the 95% CI for each trial. Only subtypes showing no evidence of heterogeneity were grouped. Within each subtypes, studies were ordered by year of reporting and alphabetical order. Squares on the plot are proportional to the weight of each study. Fixed effect and random effects models summary estimates are depicted in boldface.
Figure 5
Figure 5
Funnel plot of standard error by logit 5-year overall survival rate. The funnel plot of studies included in the meta-analysis of 5-year overall survival rate illustrates the standard error and logit of 5-year overall survival rate.
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