AI Article Synopsis
- The study aimed to compare the effectiveness of reduced intensity conditioning (RIC) versus myeloablative conditioning (MAC) in stem cell transplantation for hematologic malignancies, focusing on survival rates and complications.
- After analyzing data from 29 studies with 6235 patients, results showed that RIC had better overall survival at one year but lower disease-free survival rates after two years compared to MAC.
- While RIC also had fewer instances of severe acute graft-versus-host disease and lower treatment-related mortality, it was associated with a higher relapse rate; overall, RIC was found to be equivalent or better than MAC in terms of overall survival but fell short in disease-free survival in the long run.
Article 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.
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