Seven RCTs (977 patients) were included.
The OR for mortality for PBSCT relative to BMT ranged from 0.50 to 1.18 across studies. The meta-analysis showed no significant difference in mortality between PBSCT and BMT; the pooled OR was 0.81 (95% CI: 0.62, 1.05, P=0.11). No significant statistical heterogeneity was detected (P=0.58).
The CD34+ cell dose did not appear to influence the results. The pooled OR was 0.59 (95% CI: 0.25, 1.40, P=0.2) for the 2 RCTs that used a dose of less than 4 million CD34+ cells/kg, and 0.83 (95% CI: 0.63, 1.10, P=0.19) for the 5 RCTs that used a dose of at least 4 million CD34+ cells/kg.
Patients with more advanced disease had a statistically significant improved survival with PBSCT. The pooled OR was 0.64 (95% CI: 0.45, 0.91, P=0.01) for the 5 RCTs (573 patients) enrolling more than 25% of patients with intermediate or advanced disease, and 1.07 (95% CI: 0.73, 1.58, P=0.70) for the 2 RCTs (440 patients) predominantly enrolling patients with early stage disease.
The funnel plot showed no clear evidence of publication bias, but publication bias could not be excluded because of the small number of studies.