Conflict of interest: None.
Comparison of reduced intensity and myeloablative conditioning regimens for stem cell transplantation in patients with malignancies: a meta-analysis
Article first published online: 23 NOV 2010
© 2010 John Wiley & Sons A/S
Volume 25, Issue 2, pages E187–E198, March/April 2011
How to Cite
Shi-Xia, X., Hai-Qin, X., Xian-Hua, T., Bo, F. and Xiang-Feng, T. (2011), Comparison of reduced intensity and myeloablative conditioning regimens for stem cell transplantation in patients with malignancies: a meta-analysis. Clinical Transplantation, 25: E187–E198. doi: 10.1111/j.1399-0012.2010.01361.x
- Issue published online: 3 APR 2011
- Article first published online: 23 NOV 2010
- Accepted for publication 30 September 2010
- condition regimen;
- reduced intensity;
Shi-Xia X, Hai-Qin X, Xian-Hua T, Bo F, Xiang-Feng T. Comparison of reduced intensity and myeloablative conditioning regimens for stem cell transplantation in patients with malignancies: a meta-analysis. Clin Transplant 2011: 25: E187–E198. © 2010 John Wiley & Sons A/S.
Abstract: Objective: The reduced intensity conditioning (RIC) stem cell transplantation is widely employed for the treatment of many hematologic malignancies, but the survival effectiveness is still unclear. This study conducted an updated meta-analysis to determine whether any significant difference could be found by using RIC vs. myeloablative conditioning (MAC) regimen for transplantation in patients with malignancies.
Methods: We electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and relevant articles (1987.01–2009.12). Comparative studies were carried out on clinical therapeutic effect of RIC and MAC on the survival outcomes and the transplantation-related complications.
Results: We obtained 1776 records, and 29 studies totaling 6235 patients have been assessed. Compared with MAC regimen, the RIC regimen had a higher overall survival (OS) at one-yr and no difference at two-yr later after transplantation. RIC regimen had significantly lower rates of disease-free survival (DFS) after two-yr follow-up, lower incidences of ≥ II degree acute graft-versus-host disease (aGVHD), and lower TRM [OR, 0.61, 95% CI (0.53, 0.69)], but with a higher relapse rate [OR, 1.88(1.41, 2.51)]. No significant difference was found in rates of cytomegalovirus (CMV) infection and chronic GVHD between the regimens.
Conclusions: This meta-analysis confirmed that compared with MAC condition regimen, the RIC regimen had a consistently equivalent or even better rate in OS, but with lower DFS at longer follow-up.