METAANALYSIS AND PROSPECTIVE METAANALYSIS IN CHILDHOOD LEUKEMIA CLINICAL RESEARCH

In this paper, we consider the role of meta-analysis and 'prospective meta-analysis' studies in childhood acute lymphocytic leukemia (ALL). In this issue, Valsecchi and Masera [1] give a thoughtful discourse, g enerally favorable to this approach. This article presents the opposit e point of view. The aims of our article are to present the implicatio ns in clinical, rather than biostatistical terms, and to provide an ex tensive literature review of the subject of meta-analysis. We conclude that treatment assessments, resulting from meta-analysis of closed st udies (retrospective) should be met with healthy skepticism. Trials re quiring international resources should be true intergroup trials with a single coordinating center, rather than prospective meta-analysis, u nless it is a question grafted onto each group's own research agenda. For example, each group might ask its own systemic control question, b ut a CNS protection question is asked collectively.