scholarly journals High-dose Therapy with Single Autologous Transplantation versus Chemotherapy for Newly Diagnosed Multiple Myeloma: A Systematic Review and Meta-analysis of Randomized Controlled Trials

2007 ◽  
Vol 13 (2) ◽  
pp. 183-196 ◽  
Author(s):  
John Koreth ◽  
Corey S. Cutler ◽  
Benjamin Djulbegovic ◽  
Rajesh Behl ◽  
Robert L. Schlossman ◽  
...  
Keyword(s):  
Systematic Review ◽  
Multiple Myeloma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Autologous Transplantation ◽  
Controlled Trials ◽  
High Dose ◽  
Newly Diagnosed ◽  
High Dose Therapy ◽  
Randomized Controlled

Thromboprophylaxis In Multiple Myeloma Patients Undergoing Immunomodulatory Therapy with Thalidomide and Lenalidomide: A Systematic Review and Meta-Analysis.

Blood ◽  
2010 ◽  
Vol 116 (21) ◽  
pp. 1090-1090
Author(s):  
Marc Carrier ◽  
Gregoire Le Gal ◽  
Jason Tay ◽  
Cynthia M. Wu ◽  
Agnes Y. Lee
Keyword(s):  
Multiple Myeloma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Newly Diagnosed ◽  
Bleeding Events ◽  
Randomized Controlled ◽  
Literature Search Strategy ◽  
Previously Treated ◽  
Data Source

Abstract Abstract 1090 Background: The incidence of venous thromboembolism (VTE) in patients with multiple myeloma (MM) is high in patients treated with thalidomide (T)- and lenalidomide (L)-based regimens containing dexamethasone (D) and/or cytotoxic chemotherapy (C). Consensus guidelines recommend routine thromboprophylaxis but reliable data from randomized controlled trials are lacking. Recent observational studies have suggested that thromboprophylaxis might be efficacious in decreasing the risk of VTE in this population. Purpose: To determine the absolute rates of VTE with and without different thromboprophylactic agents (ASA, warfarin, low-molecular-weight-heparin [LMWH]) in patients with newly diagnosed or previously treated MM receiving T- or L-based regimens. Data Source: A systematic literature search strategy was conducted using MEDLINE, EMBASE, the Cochrane Register of Controlled Trials and all EBM Reviews of published studies up to Jan 2010. Results: A total of 66 studies were included in the analyses. Of these, 61 (4264 patients) and 5 (1119 patients) assessed T- and L-based regimens, respectively. Thalidomide-based regimens The rates of VTE (per 100 patient-cycles) in patients with newly diagnosed MM treated with T-based regimens: The rates of VTE (per 100 patient-months) in patients with previously treated MM managed with T-based regimens: Lenalidomide-based regimens The rates of VTE (per 100 patient-cycles) in patients with newly diagnosed MM treated with L-based regimens: The rate VTE (per 100 patient-months) in patients with previously treated MM managed with L-based regimens: None of the studies reported major bleeding events. Limitations: The definition for VTE varied across studies. Most studies did not outline the diagnostic criteria for VTE. Data are not available (NA) for all prophylaxis regimens. Conclusion: Patients with newly diagnosed or previously treated MM receiving T- or L-based regimens are at high risk of VTE. It is uncertain whether thromboprophylaxis provides a clear benefit, especially in those receiving L-based therapy or have previously treated disease. Randomized controlled trials are needed to address this important clinical need. Disclosures: Lee: Eisai: Research Funding; Sanofi Aventis: Consultancy, Honoraria; Leo Pharma: Consultancy; Pfizer: Consultancy, Honoraria; Bayer: Honoraria; Boehringer Ingelheim: Consultancy, Honoraria, Speakers Bureau.

Systematic Review and Meta-Analysis of Randomized Controlled Trials of Erythropoietin in Multiple Myeloma.

Blood ◽  
2004 ◽  
Vol 104 (11) ◽  
pp. 232-232
Author(s):  
Heloisa P. Soares ◽  
Ambuj Kumar ◽  
Franco Silvestris ◽  
Benjamin Djulbegovic
Keyword(s):  
Systematic Review ◽  
Multiple Myeloma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Current Evidence ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Epoetin Alpha

Abstract Background: The current approach for treating anemia in multiple myeloma (MM) patients entails prescribing recombinant erythropoetin (EPO) only if chemotherapy fails initially to raise hemoglobin (Hb) levels. However, this practice is not based on synthesis of the totality of evidence obtained from data of all trials testing EPO exclusively in myeloma patients. Objective: To conduct a systematic review/ meta-analysis (SR/MA) regarding the use of EPO in MM patients. Methods: We conducted a SR of all randomized controlled trials (RCTs) that studied the effect of EPO exclusively in MM patients. We searched all major electronic databases (MEDLINE, LILACS, EMBASE and the Cochrane Controlled Trials Register) as well as performing hand searches of relevant meeting proceedings (ASH, ASCO, EHA), and ongoing NCI trials. We included RCTs that had at least 10 patients in each arm and had compared the use of EPO against a control group. We also identified trials that compared different doses of EPO. We excluded trials that enrolled patients treated with high-dose myeloablative chemotherapy followed by stem cell transplantation or hemodialysis. Results: We identified more than 500 relevant studies; 6 trials met our eligibility criteria and were included in the analysis. Five trials (4 published as full text manuscripts and 1 as the abstract) compared epoetin alpha against a control [placebo (2 trials) or no therapy with or without specification of red cells transfusion trigger level (3 trials)] in anemic MM patients. One trial compared 2 different schedules of epoetin alpha. No trial tested the effect of darbopoeitin. All 5 trials that studied EPO against controls used initial doses of 150 IU 3x/week SC with the possibility of increasing to 300 IU if necessary. In the majority of trials the patients had been receiving chemotherapy at the time EPO was administered. The number of patients included in each trial ranged from 24 to 145. All trials concluded that EPO was superior to a placebo or no treatment in terms of Hb increase. Two trials also concluded that EPO improves quality of life. Our meta-analysis showed that hematological response was favored in the group receiving EPO [relative risk (RR) 7.75; 95% CI 4.19 to 14.35, 4 trials, n = 272]. Mean Hb level improvement with EPO was also significant [weighted mean difference (WMD) 2.29; 95% CI2.00 to -2.58, 3 trials, n = 235]. In terms of adverse events, hypertension was more often found in the EPO arm [RR 5.80; 95% CI 1.30-25.90, 4 trials, n = 290]. Survival and data related to tumor response were not available in all trials. Critical appraisal indicated that available evidence was modest in quantity (5 trials, n= 385 total patients enrolled) and poorly reported in all important methodological domains. Conclusion: Available body of evidence suggests that EPO improves hematological outcomes in patients with myeloma. However, the quality of current evidence is insufficient, data on most important patients’ outcomes are lacking (e.g. survival etc.), thus preventing us from making definitive recommendations regarding the role of EPO in managing anemia in the myeloma setting. A definitive RCT to resolve the role of EPO in myeloma is indicated.

Lenalidomide and Dexamethasone in Newly Diagnosed Multiple Myeloma Patients: Meta-analysis of Efficacy in Pivotal Randomized Controlled Trials

2019 ◽  
Vol 19 (10) ◽  
pp. e9-e10
Author(s):  
Salomon Manier ◽  
Suzanne Robinson ◽  
Melody Owen ◽  
Sujith Dhanasiri ◽  
Andrew Frederickson ◽  
...  
Keyword(s):  
Multiple Myeloma ◽  
Randomized Controlled Trials ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Newly Diagnosed ◽  
Randomized Controlled
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