School of Public Health, Zhejiang Chinese Medical University, Hangzhou, P.R. China.
The Second Clinical Medical College, Zhejiang Chinese Medical University, Hangzhou, Zhejiang, P.R. China.
Medicine (Baltimore). 2023 Oct 6;102(40):e35456. doi: 10.1097/MD.0000000000035456.
Multiple myeloma (MM) is a malignant plasma cell disease. In recent years, several systematic reviews, and meta-analyses have been published on treatment protocols, including autologous stem cell transplantation for MM.
Web of Science, PubMed, Embase, and Cochrane Library were searched to systematically summarize the quality of the methodology and evidence of meta-analyses regarding treatment of MM including autologous stem cell transplantation.
Total 11 meta-analyses were included. The preferred reporting items for systematic reviews and meta-analyses evaluation revealed that the quality of included reviews was affected by possible unevaluated bias between studies and the lack of protocol and registration. The AMSTAR2 scale indicated that the quality of the methodology of included reviews ranged from very low to moderate. The grading, assessment, development, and evaluation of recommendations evaluation showed that among the included outcome indicators, most of them are of low quality.
This overview suggested that the combination of drugs has improved patient survival rates, efficacy and safety compared with the standard regimen. However, the strength of the evidence is uneven and due to methodological errors, the results should be interpreted with caution in order to provide a reference for further improvement of the study design. The methodological quality of the relevant meta-analysis needs to be further improved.
多发性骨髓瘤(MM)是一种恶性浆细胞疾病。近年来,已经发表了几项关于治疗方案的系统评价和荟萃分析,包括多发性骨髓瘤的自体干细胞移植。
系统检索了 Web of Science、PubMed、Embase 和 Cochrane Library,以系统总结关于包括自体干细胞移植在内的 MM 治疗的荟萃分析方法学和证据的质量。
共纳入 11 项荟萃分析。系统评价和荟萃分析报告的首选条目评估显示,纳入研究之间可能存在未评估的偏倚以及缺乏方案和注册,这会影响综述的质量。AMSTAR2 量表表明,纳入综述的方法学质量从极低到中等不等。推荐评估、制定、发展和评价表明,在纳入的结局指标中,大多数为低质量。
本综述表明,与标准方案相比,药物联合治疗可提高患者的生存率、疗效和安全性。但是,证据的强度参差不齐,由于方法学错误,结果应谨慎解释,以便为进一步改进研究设计提供参考。相关荟萃分析的方法学质量需要进一步提高。