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基因治疗在范可尼贫血症中的作用:系统综述和文献回顾及未来方向

Role of gene therapy in Fanconi anemia: A systematic and literature review with future directions.

机构信息

Medical College, Aga Khan University, Karachi, Pakistan.

Division of Hematology, Brigham and Women's Hospital, Boston, MA, USA.

出版信息

Hematol Oncol Stem Cell Ther. 2021 Dec;14(4):290-301. doi: 10.1016/j.hemonc.2021.02.001. Epub 2021 Mar 7.

Abstract

Gene therapy (GT) has been reported to improve bone marrow function in individuals with Fanconi anemia (FA); however, its clinical application is still in the initial stages. We conducted this systematic review, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, to assess the long-term safety and clinical outcomes of GT in FA patients. Electronic searches from PubMed, Web of Science, Cochrane Library, and Google Scholar were conducted and full texts of articles meeting our inclusion criteria were reviewed. Three clinical trials were included, with a total of nine patients and mean age of 10.7 ± 5.7 years. All patients had lentiviral-mediated GT. A 1-year follow-up showed stabilization in blood lineages, without any serious adverse effects from GT. A metaregression analysis could not be conducted, as very little long-term follow-up data of patients was observed, and the median survival rate could not be calculated. Thus, we can conclude that GT seems to be a safe procedure in FA; however, further research needs to be conducted on the longitudinal clinical effects of GT in FA, for a better insight into its potential to become a standard form of treatment.

摘要

基因治疗 (GT) 已被报道可改善范可尼贫血 (FA) 个体的骨髓功能;然而,其临床应用仍处于初始阶段。我们按照系统评价和荟萃分析的首选报告项目 (PRISMA) 指南进行了这项系统评价,以评估 GT 在 FA 患者中的长期安全性和临床结局。从 PubMed、Web of Science、Cochrane 图书馆和 Google Scholar 进行了电子检索,并对符合纳入标准的文章全文进行了回顾。共纳入了三项临床试验,共 9 名患者,平均年龄为 10.7±5.7 岁。所有患者均接受了慢病毒介导的 GT。1 年随访显示血液谱系稳定,无 GT 引起的严重不良事件。由于观察到的患者长期随访数据很少,无法进行荟萃回归分析,也无法计算中位生存率。因此,我们可以得出结论,GT 在 FA 中似乎是一种安全的治疗方法;然而,需要对 GT 在 FA 中的纵向临床效果进行进一步研究,以更好地了解其成为标准治疗形式的潜力。

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