The Non-hodgkin Lymphoma Treatment and Side Effects: A Systematic Review and Meta-analysis

Objectives: This paper aims to review studies regarding side effects found during Non- Hodgkin Lymphoma treatment, to suggest the drug class most associated with these effects, as well as the most prevalent side effect grade. Methods: This review is registered in PROSPERO (IDCRD42022295774) and followed the PICOS strategy and PRISMA guidelines. The search was carried out in the databases PubMed/ MEDLINE, Scientific Electronic Library Online, and DOAJ. Medical Subject Headings Terms were used and quantitative studies with conclusive results regarding side effects during the non-Hodgkin lymphoma treatment were selected. Patent information was obtained from google patents. Results: Monoclonal antibodies were the main drug class associated with side effects during NHL therapy. The combination of Rituximab (Rituxan^®; patent EP1616572B) and iInotuzumab (Besponsa ^®; patent EP1504035B3) was associated with a higher incidence of thrombocytopenia (p < 0.05), while the combination of Rituximab and Venetoclax (Venclexta^®; patent CN107089981A) was associated with a higher incidence of neutropenia (p < 0.05) when compared to Bendamustine combinations (Treanda™; patent US20130253025A1). Meta-analysis revealed a high prevalence of grade 3-4 neutropenia and thrombocytopenia in men. Finally, Americans and Canadians experienced a higher prevalence of these side effects, when compared to others nationalities (p < 0.05). Conclusion: Patents regarding the use of monoclonal antibodies in NHL treatment were published in the last year. Monoclonal antibodies associated with neutropenia (grade 3-4) and thrombocytopenia, especially in North American men treated for NHL, and with an average age of 62 years demonstrated importance in this study.