title: Comparison of reduced intensity and myeloablative conditioning regimens for stem cell transplantation in patients with malignancies: a meta-analysis.
abstract: OBJECTIVE
  The reduced intensity conditioning (RIC) stem cell transplantation is widely employed for the treatment of many hematologic malignancies, but the survival effectiveness is still unclear. This study conducted an updated meta-analysis to determine whether any significant difference could be found by using RIC vs. myeloablative conditioning (MAC) regimen for transplantation in patients with malignancies.
  
  
  METHODS
  We electronically searched the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, and relevant articles (1987.01-2009.12). Comparative studies were carried out on clinical therapeutic effect of RIC and MAC on the survival outcomes and the transplantation-related complications.
  
  
  RESULTS
  We obtained 1776 records, and 29 studies totaling 6235 patients have been assessed. Compared with MAC regimen, the RIC regimen had a higher overall survival (OS) at one-yr and no difference at two-yr later after transplantation. RIC regimen had significantly lower rates of disease-free survival (DFS) after two-yr follow-up, lower incidences of ≥ II degree acute graft-versus-host disease (aGVHD), and lower TRM [OR, 0.61, 95% CI (0.53, 0.69)], but with a higher relapse rate [OR, 1.88(1.41, 2.51)]. No significant difference was found in rates of cytomegalovirus (CMV) infection and chronic GVHD between the regimens.
  
  
  CONCLUSIONS
  This meta-analysis confirmed that compared with MAC condition regimen, the RIC regimen had a consistently equivalent or even better rate in OS, but with lower DFS at longer follow-up.
authors.affiliation: Department of Medical Information, Navy General Hospital, Beijing, China. shixia@rocketmail.com
authors.forename: Xu
authors.initials: X
authors.lastname: Shi-Xia
authors.forename: Xu
authors.initials: X
authors.lastname: Hai-Qin
authors.forename: Tang
authors.initials: T
authors.lastname: Xian-Hua
authors.forename: Feng
authors.initials: F
authors.lastname: Bo
authors.forename: Tang
authors.initials: T
authors.lastname: Xiang-Feng
mesh_terms: D002986:Clinical Trials as Topic; D006086:Graft vs Host Disease / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000628:therapy*; D006801:Humans; D019653:Myeloablative Agonists / Q000627:therapeutic use*; D033581:Stem Cell Transplantation; D019172:Transplantation Conditioning; D016896:Treatment Outcome
chemical_list: D019653:Myeloablative Agonists