Bone Marrow Versus Peripheral Blood Stem Cell Transplant in Lymphoma: A Systematic Review and Meta-Analysis.

OBJECTIVES: The choice of whether to use bone marrow or peripheral blood in autologous transplantation remains controversial. Posttransplant relapse and long-term survival are critical issues. MATERIALS AND METHODS: Studies that compared bone marrow transplant versus peripheral blood stem cell transplant in lymphoma patients were searched. Our search resulted in 15 studies. RESULTS: Pooled data showed contradictory results with no conclusive differences in overall survival (for randomized controlled trials vs nonrandomized controlled trials: hazard ratio = 0.69 vs 1.17; 95% confidence interval, 0.44-1.10 vs 0.90-1.51; and P = .12 vs P = .25), progression-free survival (for randomized controlled trials vs nonrandomized controlled trials: hazard ratio = 0.89 vs 1.14; 95% confidence interval, 0.57-1.38 vs 0.82-1.58; and P = .60 vs P = .43), and relapse rates. However, we observed an overall trend toward lower relapse rate after bone marrow transplant. Lower relapse rate was likely associated with better progression-free survival (P = .052), and lower transplant-related mortality was associated with better overall survival (P = .043). CONCLUSIONS: Autologous bone marrow transplant with mobilization should be reconsidered for lymphoma patients to reduce recurrence and improve quality of life. More powered randomized controlled trials are warranted to update our findings.