Division of Pediatric Hematology and Oncology, Department of Pediatrics, Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.
Eur J Haematol. 2019 Dec;103(6):564-572. doi: 10.1111/ejh.13322. Epub 2019 Oct 6.
There are controversial data regarding the relationship between hematopoietic stem cell transplantation and arrhythmias. This meta-analysis was performed to evaluate the incidence of arrhythmias in patients following hematopoietic stem cell transplantation (HSCT).
A literature search was conducted utilizing MEDLINE, EMBASE, and Cochrane Databases from inception through April 2019. Pooled incidence with 95% confidence interval (CI) were calculated using random-effects meta-analysis. The protocol for this meta-analysis is registered with PROSPERO (International Prospective Register of Systematic Reviews; no. CRD42019131833).
Thirteen studies consisting of 10,587 patients undergoing HSCT were enrolled in this systematic review. Overall, the pooled estimated incidence of all types of arrhythmias following HSCT was 7.2% (95% CI: 4.9%-10.5%). With respect to the most common type of arrhythmia, the pooled estimated incidence of atrial fibrillation/atrial flutter (AF/AFL) within 30 days following HSCT was 4.2% (95% CI: 1.7%-9.6%). Egger's regression test demonstrated no significant publication bias in this meta-analysis of post-HSCT arrhythmia incidence.
The overall estimated incidence of arrhythmias following HSCT was 7.2%. Future large scale studies are needed to further elucidate the significance and clinical impact of arrhythmias in post-HSCT patients.
关于造血干细胞移植与心律失常之间的关系，目前存在一些争议数据。本荟萃分析旨在评估造血干细胞移植（HSCT）后患者心律失常的发生率。
通过检索 MEDLINE、EMBASE 和 Cochrane 数据库，从建库至 2019 年 4 月，对所有相关研究进行文献检索。使用随机效应荟萃分析计算合并发生率及其 95%置信区间（CI）。本荟萃分析的方案已在 PROSPERO（国际前瞻性系统评价注册库；注册号：CRD42019131833）上注册。
本系统评价共纳入 13 项研究，共纳入 10587 例接受 HSCT 的患者。总体而言，HSCT 后所有类型心律失常的合并估计发生率为 7.2%（95%CI：4.9%-10.5%）。关于最常见的心律失常类型，HSCT 后 30 天内心房颤动/心房扑动（AF/AFL）的合并估计发生率为 4.2%（95%CI：1.7%-9.6%）。Egger 回归检验显示，本荟萃分析中 HSCT 后心律失常发生率无明显发表偏倚。
HSCT 后心律失常的总体估计发生率为 7.2%。需要进一步开展大规模研究以阐明 HSCT 后患者心律失常的意义和临床影响。
