Lymphoma
MEDLINE® In-Process & Other Non-Indexed Citations (Ovid) (December 12, 2003), MEDLINE (Ovid) (1966 through August week two, 2005), HealthStar (Ovid) (1975 through November 2003, limited to nonMEDLINE), EMBASE (1980 through August [week 34] 2005), CINAHL (Ovid) (1982 through December 2003), and the Cochrane Library (2005, Issue 3) databases were searched. In MEDLINE, "Exp lymphoma/" (Medical subject heading [MeSH]) was combined with "exp lymphoma, large-cell/" (MeSH), "lymphoma.mp." (textword), and each of the following phrases used as text words: "rituxan.mp.," "rituximab.mp.," "ritux:.mp.," "idec.mp." combined with "c2b8.mp." or "c2b?.mp.," "anti -cd20.mp.," "anticd-20.mp.," "anticd20.mp.," "mabthera.mp.," and "rituxin.mp." These terms were then combined with the search terms for the following publication types and study designs: practice guidelines, systematic reviews, meta-analyses, reviews, randomized controlled trials, controlled clinical trials, and clinical trials. Searches in the other bibliographic databases were similar. The MEDLINE search focused on retrieving randomized controlled trials.
In addition, conference proceedings of American Society of Hematologists (ASH) (1998-2004) and the American Society of Clinical Oncology (ASCO; 1997-2005) were searched for abstracts of relevant trials. Personal files were also consulted.
Relevant bibliographic citations were selected by two reviewers. All the evidence was reviewed by two reviewers.
Chronic Lymphocytic Leukemia (CLL)
MEDLINE (Ovid) (1966 through August week 2, 2005), EMBASE (1980 through August [week 34] 2005), MEDLINE® In-Process & Other Non-Indexed Citations (Ovid) (January 10, 2003), CANCERLIT (Ovid) (1975 through October 2002, limited to nonMEDLINE), HealthStar (OVID) (1975 through October 2002, limited to nonMEDLINE), CINAHL (1982 through December 2002), and the Cochrane Library (Ovid) (2002, Issue 4; the Cochrane Central Register of Controlled Trials and Cochrane Database of Systematic Reviews were searched) databases were searched. In MEDLINE, "Leukemia, lymphocytic/" (MeSH) was combined with "exp leukemia, lymphocytic, chronic/" (MeSH), "chronic lymphocytic leukemia.mp." (textword), "chronic lymphocytic leukaemia.mp.," "CLL.mp.," and each of the following phrases used as textwords: "rituxan.mp.," "rituximab.mp.," "ritux:.mp.," "idec.mp." combined with "c2b8.mp." or "c2b?.mp.," "anti -cd20.mp.," "anticd-20.mp.," "anticd20.mp.," and "mabthera.mp.". Searches in the other bibliographic databases were similar.
In addition, conference proceedings of American Society of Hematologists (1996-2004) and American Society of Clinical Oncology (1995-2005) were searched for abstracts of relevant trials. The Canadian Medical Association Infobase (http://mdm.ca/cpgsnew/cpgs/index.asp) and the National Guideline Clearinghouse (http://www.guideline.gov) were also searched for existing evidence -based practice guidelines. Personal files were also reviewed.
Relevant bibliographic citations were selected by two reviewers in the original literature search. Evidence was reviewed by two reviewers.
Study Selection Criteria
Inclusion Criteria
Lymphoma
Articles were selected for inclusion in this systematic review of the evidence if they were fully published reports or published abstracts in the English language of:
- Randomized controlled trials, systematic reviews, meta-analyses, or evidence-based practice guidelines
- Studies that include adult patients with lymphoma of any type, at any stage, and any histology
- Studies comparing rituximab alone with non-rituximab regimens or comparing rituximab combination therapy with non-rituximab regimens
- Studies evaluating one or more of the following outcomes: overall survival, disease control (progression-free survival, event-free survival, time-to-treatment failure, or response duration), response rate, quality of life, or toxicity.
CLL
Articles were selected for inclusion in this systematic review of the evidence if they were fully published reports or published abstracts in the English language of:
- Primary studies of any design type, systematic reviews, meta-analyses, or evidence-based clinical practice guidelines
- Studies that include patients with CLL or small lymphocytic lymphoma (SLL). For studies including patients with various histologic subtypes of lymphoproliferative disorders, outcomes of patients with CLL must be identified separately.
- Studies evaluating rituximab alone or in combination with other agents
- Studies evaluating at least one of the following outcomes were reported: overall survival, disease control (progression-free survival, time-to-treatment failure, event-free survival, or response duration), or toxicity. If response rate is reported, at least one of the above outcomes must also be reported to be included.
Exclusion Criteria
Lymphoma
Letters, comments, books, notes, and editorial publication types were not considered.
CLL
The following were not considered:
- Letters, comments, and editorial publication types
- Reports evaluating patients undergoing stem cell transplantation
- Studies with fewer than 10 patients
Article Selection
Lymphoma
Citations in the original literature search were reviewed by two reviewers for inclusion. Citations were not blinded for author, journal name, institution, or results. Each citation was scored as: "Yes" (inclusion criteria were met, no exclusion criteria were met), "No" (one or more exclusion criteria were met), or "Maybe" (unclear from the citation if article meets any criteria). The full-length article was retrieved if the citation was scored "yes" or "maybe" by at least one reviewer, and inclusion and exclusion criteria were applied to the full article, if necessary. Inter-observer kappa coefficients were calculated using GraphPad QuickCalcs © (GraphPad Software, Inc.) (http://graphpad.com/quickcalcs/kappa1.cfm).
CLL
Citations in the original literature search were reviewed by two reviewers for inclusion. Citations were not blinded for author, journal name, institution, or results. Each citation was scored as: "Yes" (inclusion criteria were met, no exclusion criteria were met), "No" (one or more exclusion criteria were met), or "Maybe" (unclear from the citation if article meets any criteria). The full-length article was retrieved if the citation was scored "yes" or "maybe" by at least one reviewer, and inclusion and exclusion criteria were applied to the full article, if necessary. Interobserver kappa coefficients were calculated using GraphPad QuickCalcs © (GraphPad Software, Inc.) (http://graphpad.com/quickcalcs/kappa1.cfm).