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Standard chemotherapy is superior to high-dose chemotherapy with autologous stem cell transplantation on overall survival as the first-line therapy for patients with aggressive non-Hodgkin lymphoma: a meta-analysis

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Abstract

Randomized controlled trials (RCTs) have reported conflicting results on the impact of high-dose chemotherapy with autologous hematopoietic stem cell transplantation (HDCT) as the first-line treatment for patients with aggressive non-Hodgkin lymphoma (NHL). We performed a systematic meta-analysis to assess the efficacy of HDCT compared to conventional chemotherapy in patients with aggressive NHL with regard to overall survival (OS) at 3 years. We gathered the data for our analysis from MEDLINE, EMBASE, Cochrane controlled trials register, Cochrane Library, and Science Citation Index (1/1990 to 11/2008) searches. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using the random effect model. Fourteen RCTs were identified that were published in full text and included a total of 2,413 patients. There was evidence that HDCT showed decreased OS (HR 1.20, 95% CI 1.05–1.37, P = 0.006) at 3 years when compared with conventional chemotherapy. The variation in OS probabilities between studies was not statistically significant (test for heterogeneity, Q = 10.14, df = 13, P = 0.683). Thus, our meta-analysis showed that HDCT in aggressive non-Hodgkin lymphoma had decreased overall survival outcome compared with conventional chemotherapy.

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Conflict of Interest

We declare that we have no financial and personal relationships with other people or organizations that can inappropriately influence our work, there is no professional or other personal interest of any nature or kind in any product, service, and company that could be construed as influencing the position presented in, or the review of, the manuscript.

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Authors and Affiliations

  1. Department of Hematology, The Affiliated DrumTower Hospital of Nanjing University Medical School, 210008, Nanjing, People’s Republic of China

    Jing Wang, Jian Ouyang, Bing Chen, Rongfu Zhou & Yonggong Yang

  2. Department of Respiratory Medicine, Nanjing Chest Hospital, 210029, Nanjing, People’s Republic of China

    Ping Zhan

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  1. Jing Wang
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  3. Jian Ouyang
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Correspondence to Jian Ouyang.

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Wang, J., Zhan, P., Ouyang, J. et al. Standard chemotherapy is superior to high-dose chemotherapy with autologous stem cell transplantation on overall survival as the first-line therapy for patients with aggressive non-Hodgkin lymphoma: a meta-analysis. Med Oncol 28, 822–828 (2011). https://doi.org/10.1007/s12032-010-9517-0

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