Early versus Deferred Treatment for Smoldering Multiple Myeloma: A Meta-Analysis of Randomized, Controlled Trials

摘要: PURPOSE Whether patients with smoldering multiple myeloma (SMM) needed to receive early interventional treatment remains controversial. Herein, we conducted a meta-analysis comparing the efficacy and safety of over deferred for SMM. METHODS MEDLINE Cochrane Library were searched May 2014 randomized controlled trials (RCTs) that assessed effect treatment. Primary outcome measure was mortality, secondary measures progression, response rate, adverse events. RESULTS Overall, 5 including 449 identified. There markedly reduced risk disease progression (Odds Ratio [OR] = 0.13, 95% confidence interval [CI] = 0.07 0.24). no significant differences in mortality rate (OR = 0.85, CI = 0.45 1.60, OR = 0.63, CI = 0.32 1.23, respectively). More arm experienced gastrointestinal toxicities (OR = 10.02, 95%CI = 4.32 23.23), constipation (OR = 8.58, 95%CI = 3.20 23.00) fatigue or asthenia (OR = 2.72, 95%CI = 1.30 5.67). No seen development acute leukemia (OR = 2.80, 95%CI = 0.42 18.81), hematologic cancer (OR = 2.07, 95%CI = 0.43 10.01), second primary tumors (OR = 3.45, 95%CI = 0.81 14.68), nor vertebral compression (OR = 0.18, 95%CI = 0.02 1.59). CONCLUSIONS Early delayed but increased toxicities, asthenia. The on compression, leukemia, hematological not statistically significant. Based current evidence, didn't significantly affect rate. However, further much larger provide more evidence.