SynthesisBone marrow transplantation2012
Comparing efficacy of reduced-toxicity allogeneic hematopoietic cell transplantation with conventional chemo-(immuno) therapy in patients with relapsed or refractory CLL: a Markov decision analysis.
Synthesis in Bone marrow transplantation, 2012. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
18 citing papers in PubMed, 4 syntheses or guidelines pooled it, 39 citations in OpenAlex.
- Liver resection versus transarterial chemoembolization for the treatment of intermediate-stage hepatocellular carcinoma.Cancer medicine · 2019Pooled it
- Clinical Practice Recommendations for Use of Allogeneic Hematopoietic Cell Transplantation in Chronic Lymphocytic Leukemia on Behalf of the Guidelines Committee of the American Society for Blood and Marrow Transplantation.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2016Pooled it
- High-dose therapy and autologous hematopoietic cell transplantation as front-line consolidation in chronic lymphocytic leukemia: a systematic review.Bone marrow transplantation · 2015Pooled it
- Mycophenolate mofetil versus methotrexate for prevention of graft-versus-host disease in people receiving allogeneic hematopoietic stem cell transplantation.The Cochrane database of systematic reviews · 2014Pooled it
- Review
- Transplant indications, guidelines and recommendations: Caveat Emptor.Bone marrow transplantation · 2022Article
- The role of allogeneic hematopoietic cell transplantation for chronic lymphocytic leukemia: A review.Frontiers in oncology · 2022Review
- Will New Drugs Replace Transplants for Chronic Lymphocytic Leukaemia?Journal of clinical medicine · 2021Review
- Allogeneic stem cell transplantation for chronic lymphocytic leukemia in the era of novel agents.Blood advances · 2020Article
- How and when I do allogeneic transplant in CLL.Blood · 2018Review
- Paradigm shifts in the management of poor-risk chronic lymphocytic leukemia.Leukemia & lymphoma · 2015Review
- Where does allogeneic stem cell transplantation fit in the treatment of chronic lymphocytic leukemia?Current hematologic malignancy reports · 2015Review
- Managing high-risk CLL during transition to a new treatment era: stem cell transplantation or novel agents?Blood · 2014Review
- Genomic aberrations deletion 11q and deletion 17p independently predict for worse progression-free and overall survival after allogeneic hematopoietic cell transplantation for chronic lymphocytic leukemia.Leukemia research · 2014Article
- Role of allogeneic transplantation in patients with chronic lymphocytic leukemia in the era of novel therapies: a review.Therapeutic advances in hematology · 2014Review
- Review
- CARs in chronic lymphocytic leukemia -- ready to drive.Current hematologic malignancy reports · 2013Review
- Markov model of CLL transplants.Bone marrow transplantation · 2012Article
Corrections and comments
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Authors and funding
5 authors at 4 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Despite therapeutic advances, relapsed/refractory CLL, particularly after fludarabine-based regimens, remains a major challenge for which optimal therapy is undefined. No randomized comparative data exist to suggest the superiority of reduced-toxicity allogeneic hematopoietic cell transplantation (RT-allo-HCT) over conventional chemo-(immuno) therapy (CCIT). By using estimates from a systematic review and by meta-analysis of available published evidence, we constructed a Markov decision model to examine these competing modalities. Cohort analysis demonstrated superior outcome for RT-allo-HCT, with a 10-month overall life expectancy (and 6-month quality-adjusted life expectancy (QALE)) advantage over CCIT. Although the model was sensitive to changes in base-case assumptions and transition probabilities, RT-allo-HCT provided superior overall life expectancy through a range of values supported by the meta-analysis. QALE was superior for RT-allo-HCT compared with CCIT. This conclusion was sensitive to change in the anticipated state utility associated with the post-allogeneic HCT state; however, RT-allo-HCT remained the optimal strategy for values supported by existing literature. This analysis provides a quantitative comparison of outcomes between RT-allo-HCT and CCIT for relapsed/refractory CLL in the absence of randomized comparative trials. Confirmation of these findings requires a prospective randomized trial, which compares the most effective RT-allo-HCT and CCIT regimens for relapsed/refractory CLL.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.