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Intensified Therapy Followed by Autologous Stem-Cell Transplantation (ASCT) versus Conventional Therapy as First-Line Treatment of Follicular Lymphoma

Lida Wang, Liping Liu, Huanwen Ma and Zhixin Sheng

To define the treatment effect of intensified therapy followed by autologous stem-cell transplantation (ASCT) compared with conventional therapy as first-line treatment of patients with follicular lymphoma (FL) in terms of overall survival (OS) and event-free survival (EFS). Medline, Embase, the Cochrane controlled trials register and the Science Citation Index were searched. Four trials were identified, covering a total of 941 subjects. The random- effects summary Hazard Ritio (HR) comparing the treatment effect on OS between intensified and conventional therapy was 0.95 [0.70, 1.30] (P=0.75), indicating that no additional survival benefit was derived from the intensified therapy followed by ASCT. A significant benefit of intensified therapy followed by ASCT as first-line treatment was detected in terms of EFS: the random-effects summary HR (intensified versus conventional therapy) was 0.59 [0.44, 0.79] (P<0.001). In conclusion, despite its superior EFS, intensified therapy followed by ASCT does not improve OS compared with conventional therapy.