| Background:Conflicting results have been reported for the impact of different doses of melphalan as a conditioning regimen for autologous stem cell transplantation(ASCT) in patients with multiple myeloma(MM). The most commonly used conditioning regimens at different research centers are melphalan 200mg/m2(MEL200) and melphalan 140mg/m2(MEL140) plus TBI/Busulfan. However, conflicting results are reported in the results of survival and side-effects, the most effective dose are still unknown. This meta-analysis collects all the studies and tries to figure out a credible evidence for the most effective dose using in melphalan treatments in conditioning regimens.Methods:The data of this meta-analysis are based on the information by PUBMED, MEDLINE, EMBASE and Cochrane Controlled Trials Register databases. This meta-analysis is performed to assess the efficacy of MEL200 and MEL140 plus TBI/Busulfan as the conditioning regimen by comparing complete remission(CR), partial remission(PR), overall survival(OS) after 45 months and event-free survival(EFS) after 35 months. Odds ratio and heterogeneity are also be added in the statistical analysis to calculated by using the I2 statistic.Results:Finally,five trials were identified which included a total of 1,341 patients. No statistically significant differences in reaching CR(OR 0.74, CI 0.49-1.13,P=0.16), PR(OR 1.17, CI 0.79-1.72,P=0.34), OS(OR 0.82, CI 0.48-1.40,P=0.47) or EFS(OR 1.03, CI 0.64-1.67,P=0.90) were observed with MEL200 compared to treatment with MEL140 plus TBI/Busulfan. Most studies showed that MEL200 could not provide a faster engraftment and lower toxicity than MEL140 plus TBI/Busulfan. But some of these studies also indicated that MEL200 could have a faster engraftment and lower toxicity than MEL140 plus TBI/Busulfan.Conclusions:There was no evidence that CR, PR, OS and EFS had significantly better results with MEL200 in MM patients. MEL200 might provide a faster engraftment and lower toxicity than MEL140 plus TBI/Busulfan. |
