PURPOSE: Whether @entity1 with smoldering multiple @entity1582 (SMM) needed to receive early interventional treatment remains controversial. Herein, we conducted a meta-analysis comparing the efficacy and safety of early treatment over deferred treatment for @entity1 with SMM. METHODS: MEDLINE and Cochrane Library were searched to May 2014 for randomized controlled trials (RCTs) that assessed the effect of early treatment over deferred treatment. Primary outcome measure was mortality, and secondary outcome measures were progression, response rate, and adverse events. RESULTS: Overall, 5 trials including 449 @entity1 were identified. There was a markedly reduced risk of disease progression with early treatment (Odds Ratio [OR]=0.13, 95% confidence interval [CI]=0.07 to 0.24). There were no significant differences in mortality and response rate (OR=0.85, 95% CI=0.45 to 1.60, and OR=0.63, 95% CI=0.32 to 1.23, respectively). More @entity1 in the early treatment arm experienced @entity344 (OR=10.02, 95%CI=4.32 to 23.23), @entity1142 (OR=8.58, 95%CI=3.20 to 23.00) and @entity1295 or @entity1395 (OR=2.72, 95%CI=1.30 to 5.67). No significant differences were seen with the development of @entity3052 (OR=2.80, 95%CI=0.42 to 18.81), @entity1583 (OR=2.07, 95%CI=0.43 to 10.01), second @entity5 (OR=3.45, 95%CI=0.81 to 14.68), nor vertebral compression (OR=0.18, 95%CI=0.02 to 1.59). CONCLUSIONS: Early treatment delayed disease progression but increased the risk of @entity344 , @entity1142 and @entity1295 or @entity1395 . The differences on vertebral compression, @entity1583 and second @entity5 were not statistically significant. Based on the current evidence, early treatment didn't significantly affect mortality and response rate. However, further much larger trials were needed to provide more evidence.

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

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['primary tumors'] @entity1295 :: ('MESH:D005221', 'Disease') :: ['fatigue'] @entity344 :: ('MESH:D005767', 'Disease') :: ['gastrointestinal toxicities'] @entity1395 :: ('MESH:D001247', 'Disease') :: ['asthenia'] @entity3052 :: ('MESH:D015470', 'Disease') :: ['acute leukemia'] @entity1582 :: ('MESH:D009101', 'Disease') :: ['myeloma'] @entity1583 :: ('MESH:D019337', 'Disease') :: ['acute leukemia, hematological cancer', 'hematologic cancer'] @entity1142 :: ('MESH:D003248', 'Disease') :: ['constipation']
@entity1582 :: (MESH:D009101,Disease) :: ['Multiple Myeloma']
