The study find that the Health Care (IQWiG) has investigated whether patients suffering from non-Hodgkin lymphoma have (better) chances of recovery when stem cells from another person are transplanted. In its final report now present, the Institute concludes that it is not possible to make statements on the benefit of this high-risk treatment. Meaningful studies are lacking for the often very small patient groups.
For some questions, the data gap is close with the help of disease-specific registries. Non-Hodgkin lymphoma (NHL) is a form of lymph node cancer, a disease of the lymphatic system. If chemotherapy and radiotherapy are insufficient, a stem cell transplantation is possible. If the transferr stem cells originate from the patient himself or herself, this is referr to as an autologous transplantation.
Since no undesired immune reaction occurs, this variant is usually preferable. However, there are also patients in whom the allogeneic variant is use. This involves the transfer of stem cells from another human being. The IQWiG researchers investigate a whole range of therapeutic situations. In some cases, they compare allogeneic stem cell transplantation with autologous stem cell transplantation, in other cases, with treatment that no longer aimed at a cure (palliative treatment).
Stem cell transplantation
IQWiG also included case series for those patient groups for whom all curative treatments had already been exhaust. However, a benefit only be derive from such studies if very clear effects are observe. The evaluation of allogeneic stem cell treatment is complicate by the fact that the various forms of the disease are rare.
Even if all types of non-Hodgkin lymphoma are considered together, there are currently only about 250 patients per year in Germany who receive allogeneic stem cell transplantation. In addition, these patients are distributed among many subgroups. For some of these extremely rare lymphomas, IQWiG therefore even evaluated international aggregated statistics from individual case reports.
Evaluated international aggregate
In the commenting procedure that followed the publication of the, IQWiG received additional information on individual studies. In total, the Institute was able to include 43 studies in the final report. Of these, 11 studies examined patients receiving palliative treatment.
The studies primarily investigated how long the patients survived. However, if there were any usable data at all, in terms of overall survival they showed no clear advantage of allogeneic stem cell transplantation over the control treatments. There are no studies that would allow conclusions to be drawn on the quality of life of affected patients.