High-dose Chemotherapy Following Autologous Stem Cell Transplantation In First-line Treatment Of Follicular Lymphoma: A Meta-analysis

ObjectiveTo assess the effectiveness and safety of high-dose chemotherapy following autologous stem cell transplantation in first-line treatment of follicular lymphoma.MethodsRandomized controlled trials (RCTs) of high-dose chemotherapy following autologous stem cell transplantation in first-line treatment of follicular lymphoma were collected from MEDLINE database(1990-2009),EMBASE database (1990-2009), OVID database (1990-2009), and the Cochrane Library(Issue2,2009). Meeting reports of ASH were hand searched. The methodological quality of included studies was evaluated, and data analyses were performed using software STATA 10.0 and Revman 4.3.ResultsA total of 4 RCTs involving 941 patients were included. The results of meta-analyses showed that HR of overall survival is 0.82,95%CI[0.49,1.15]; HR of event free survival is 0.35,95%CI[0.24,0.47]; RR of total remission rate is 0.35, 95%CI[0.96,1.30];RR of secondary cancers incidence rate is 1.68,95%CI[0.47,6.07].ConclusionsAccording to the present evidence, high-dose chemotherapy following autologous stem cell transplantation can not improve overall survival and total remission rate, but can improve event free survival, and do not increase the secondary cancers incidence rate. However, more high-quality, multiple-center, large-sample randomized controlled trials are required.