Cancer: Stem cell transplantation, systematic review and aggregate data meta-analysis

Autologous stem cell transplantation for malignancy: a systematic review of the literature

Are stem cell transplants better than chemotherapy to treat some types of cancer?

What was this study about?

Sometimes doctors use a treatment called autologous stem cell transplantation to treat people with different types of cancer. This is where doctors remove some stem cells when the cancer seems to have disappeared (is in remission). These stem cells are frozen, and the person is given high doses of chemotherapy (drugs). Then the stem cells are put back into the body so that they can create new blood cells.

We carried out a systematic review to compare two different ways of treating people who had a range of different cancers - these included cancer of the breast, lung, testes, ovary, bone marrow (also called multiple myeloma) or lymphatic system. The two treatments were:

  • Chemotherapy
  • High doses of chemotherapy with autologous stem cell transplantation.

We brought together information from reports of similar randomised controlled trials.

What difference did this study make?

All of the trials found were small. This means it was hard to work out whether high dose therapy with stem cell transplantation works better (or worse) than chemotherapy. Costs of the transplant treatment were much higher than the costs of chemotherapy.

The researchers recommended that more trials should be done, and that these trials should look at the costs of the different treatments and the long term side-effects, as well as how well they work.

Simnett SJ, Stewart LA, Sweetenham J, Morgan G, Johnson PW. Autologous stem cell transplantation for malignancy: a systematic review of the literature. Clinical Laboratory and Haematology. 2000; 22:61-72

Type of study

Meta-analyses

Contact details

MRCCTU.meta-analysis@ucl.ac.uk

Who funded the study?

The UK NHS Health Technology Assessment Programme.

When did it take place?

This study was published in 2000. The trials included were done between 1985 and 1995.

Where did it take place?

The study was carried out in the UK, but brought together results of trials from around the world.

Who was included?

Patients with different cancers who took part in randomised controlled trials comparing chemotherapy with autologous stem cell transplantation. The study brought together 18 trials from all over the world.