Autologous stem cell transplantation for malignancy: A systematic review of the literature

S. J. Simnett, L. A. Stewart, J. Sweetenham, G. Morgan, P. W.M. Johnson

Research output: Contribution to journalReview articlepeer-review

16 Scopus citations

Abstract

A systematic review of the literature was undertaken to assess what published evidence is currently available to support the increasing use of autologous stem cell transplantation (ASCT), and to evaluate the published data with regard to the comparative cost of high-dose and conventional therapy. The review aimed to identify all published, randomized controlled trials (RCTs) comparing high-dose therapy (HDT) with ASCT versus conventional chemotherapy (CC) in acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, and breast, lung, testicular and ovarian cancer. The review also aimed to identify all studies that had compared the cost of the two treatment strategies. Reports were identified by systematic searches of Cancerlit, Embase and Medline, and handsearching of several conference proceedings. Where possible, pooled odds ratios (ORs) were calculated according to the fixed-effect model. A total of 18 randomized trials were identified in acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin's disease, multiple myeloma, and breast, lung and testicular cancer. Trials were generally small and no disease site had sufficient information to determine reliably whether high-dose therapy with autologous transplant is more effective than CC. Five studies were identified that compared the cost of the two treatments. These found the cost of HDT to be between one and four times higher than that of CC. Further randomized trials are required. Where appropriate, these should include economic assessment and assessments of long-term toxicity.

Original languageEnglish (US)
Pages (from-to)61-72
Number of pages12
JournalClinical and Laboratory Haematology
Volume22
Issue number2
DOIs
StatePublished - 2000
Externally publishedYes

Keywords

  • Autologous stem cell transplantation
  • Conventional chemotherapy
  • High-dose therapy

ASJC Scopus subject areas

  • Hematology

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