Table 3 Summary of evidence for tandem autologous versus autologous-allogeneic hematopoietic cell transplantation in patients with multiple myeloma
Quality assessment | No of patients | Effect | ||||
|---|---|---|---|---|---|---|
No of studies | Design | Risk of bias | Auto-allo HCT | Auto-auto HCT | Relative (95% CI) | Absolute |
Overall response rate | ||||||
3 | Biologically randomized trials | very serious1,2 | 248/275 (90.2%) | 204/223 (91.5%) | RR 0.98 (0.92 to 1.05) | 18 fewer per 1000 (from 73 fewer to 46 more) |
Complete response | ||||||
5 | Biologically randomized trials | very serious1,2 | 257/456 (56.4%) | 254/674 (37.7%) | RR 1.65 (1.25 to 2.19) | 245 more per 1000 (from 94 more to 448 more) |
At least very good partial response | ||||||
1 | Biologically randomized trials | very serious1,2 | 113/156 (72.4%) | 272/366 (74.3%) | RR 0.97 (0.87 to 1.09) | 22 fewer per 1000 (from 97 fewer to 67 more) |
Event-free survival (ITT) | ||||||
3 | Biologically randomized trials | serious1 | 414 | 815 | HR 0.83 (0.60 to 1.15) | - |
Event-free survival (per-protocol) | ||||||
4 | Biologically randomized trials | very serious1,2 | 174 | 235 | HR 0.78 (0.58 to 1.05) | - |
Overall survival (ITT) | ||||||
3 | Biologically randomized trials | serious1 | 414 | 815 | HR 0.80 (0.48 to 1.32) | - |
Overall survival (per-protocol) | ||||||
2 | Biologically randomized trials | very serious1,2 | 83 | 131 | HR 0.88 (0.33 to 2.35) | - |
Non-relapse mortality | ||||||
4 | Biologically randomized trials | serious1 | 50/363 (13.8%) | 25/684 (3.7%) | RR 3.55 (2.17 to 5.80) | 93 more per 1000 (from 43 more to 175 more) |
Grade II-IV GVHD 3 | ||||||
4 | Biologically randomized trials | serious1 | 126/485 (26%) | - | Proportion 28.26 (20.65 to 36.55) | - |
Chronic GVHD 3 | ||||||
4 | Biologically randomized trials | serious1 | 206/356 (57.9%) | - | Proportion 60.69 (50.65 to 70.29) | - |