A Cochrane review [Abstract] 1 included 15 studies with a total of 3 079 patients. Overall treatment-related mortality was 6.0% in the HDT group and not significantly different compared to conventional chemotherapy (OR 1.33 95% CI 0.91 to 1.93). 13 studies including 2 018 patients showed significantly higher complete tumour response (CR) rates in the group receiving HDT (OR 1.32 95% CI 1.09 to 1.59). However, HDT did not have an effect on overall survival (OS), when compared to conventional chemotherapy. The pooled hazard ratio (HR) was 1.04 (95% CI 0.91 to 1.18). Subgroup analysis of prognostic groups according to International Prognostic Index score (IPI) did not show any survival difference between HDT and controls in 12 trials (low and low-intermediate risk IPI: HR 1.41 95% CI 0.95 to 2.10; high-intermediate and high risk IPI: HR 0.97 95% CI 0.83 to 1.13. Event-free survival (EFS) also showed no significant difference between HDT and CT (HR 0.93 95% CI 0.81 to 1.07). There was no evidence for an association between other possible risk factors such as the proportion of patient with diffuse large cell lymphoma, protocol adherence, HDT strategy, response status before HDT, conditioning regimens and methodological issues and the results.
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