Abstract
<h3>To the Editor.</h3> —The April 15 issue of<i>JAMA</i>contained an evaluation of the cost-effectiveness of high-dose chemotherapy with autologous bone marrow transplantation (ABMT) for metastatic breast cancer.<sup>1</sup>Simultaneously, another article evaluating the same treatment was published in the<i>Journal of Clinical Oncology</i>.<sup>2</sup>At first glance, the two articles appear to reach opposite conclusions. As the authors of the two articles, we thought it would be helpful to reconcile the apparently different conclusions. The<i>Journal of Clinical Oncology</i>article<sup>2</sup>was a comprehensive literature review. Its main conclusions were that (1) there are no well-controlled studies documenting that high-dose chemotherapy with ABMT is superior to conventional care, and (2) a crude comparison of clinical series reveals that the two treatments have essentially the same median survival rates (16.2 months for conventional care vs 16 months for high-dose chemotherapy with ABMT), median disease-free survival rates (8.8 months vs 8.3
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