Evidence map›Paper›PMID 37193978›Full record

SynthesisBMC cancer2023

Treatment benefit of upfront autologous stem cell transplantation for newly diagnosed multiple myeloma: a systematic review and meta-analysis.

Chi-Maw Lin, Lih-Chyun Chang, Wen-Yi Shau, Chi-Ling Chen, Chi-Yuan Yao, Feng-Ming Tien

Open access · goldAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in BMC cancer, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

  1. Article
  2. Article
  3. Article
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Chi-Maw LinGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Lih-Chyun ChangGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Wen-Yi ShauGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chi-Ling ChenGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Chi-Yuan YaoGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Feng-Ming TienGraduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. b92401007@gmail.com.
National Taiwan University · TWNational Taiwan University Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundUpfront high-dose therapy (HDT) followed by autologous stem cell transplantation (ASCT) remains a profitable strategy for newly diagnosed multiple myeloma (MM) patients in the context of novel agents. However, current knowledge demonstrates a discrepancy between progression-free survival (PFS) and overall survival (OS) benefit with HDT/ASCT.

methodsWe conducted a systematic review and meta-analysis that included both randomized controlled trials (RCTs) and observational studies evaluating the benefit of upfront HDT/ASCT published during 2012 to 2023. Further sensitivity analysis and meta-regression were also performed.

resultsAmong the 22 enrolled studies, 7 RCTs and 9 observational studies had a low or moderate risk of bias, while the remaining 6 observational studies had a serious risk of bias. HDT/ASCT revealed advantages in complete response (CR) with an odds ratio (OR) of 1.24 and 95% confidence interval (CI) 1.02 ~ 1.51, PFS with a hazard ratio (HR) of 0.53 (95% CI 0.46 ~ 0.62), and OS with an HR of 0.58 (95% CI 0.50 ~ 0.69). Sensitivity analysis excluding the studies with serious risk of bias and trim-and-fill imputation fundamentally confirmed these findings. Older age, increased percentage of patients with International Staging System (ISS) stage III or high-risk genetic features, decreased proteasome inhibitor (PI) or combined PI/ immunomodulatory drugs (IMiD) utilization, and decreased follow-up duration or percentage of males were significantly related to a greater survival advantage with HDT/ASCT.

conclusionsUpfront ASCT remains a beneficial treatment for newly diagnosed MM patients in the period of novel agents. Its advantage is especially acute in high-risk MM populations, such as elderly individuals, males, those with ISS stage III or high-risk genetic features, but is attenuated with PI or combined PI/IMiD utilization, contributing to divergent survival outcomes.

Indexed as

Hematopoietic Stem Cell TransplantationMultiple MyelomaAgedAntineoplastic Combined Chemotherapy ProtocolsDisease-Free SurvivalHumansMaleStem Cell TransplantationTransplantation, AutologousAutologous stem-cell transplantationMeta-analysisMultiple myelomaSurvivalSystematic review

Identifiers

PMID37193978
PMCPMC10190007
OpenAlexW4376871638

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.