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两种不同的移植预处理方案联合放疗和化疗治疗儿童白血病：系统评价和荟萃分析。

Two Different Transplant Preconditioning Regimens Combined with Irradiation and Chemotherapy in the Treatment of Childhood Leukemia: Systematic Review and Meta-Analysis.

机构信息

Inner Mongolia People's Hospital Pediatric Hematology, Hohhot, China.

出版信息

J Healthc Eng. 2022 Mar 18;2022:2825712. doi: 10.1155/2022/2825712. eCollection 2022.

DOI:10.1155/2022/2825712
PMID:35340233
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8956434/
Abstract

OBJECTIVE

To observe the therapeutic effect and the incidence of adverse reactions of total body irradiation plus cyclophosphamide (TBI/CY) and busulfan plus cyclophosphamide (BU/CY) in the treatment of pediatric hematopoietic stem cell transplantation.

METHODS

By searching the Cochrane Library, PubMed, Web of Knowledge, Embase, Chinese Biomedical Literature Database (CBM), and screening randomized controlled trials (RCTs), quality evaluation and data extraction were performed for the included literature, and meta-analysis was performed for RCTs included at using Review Manager 5.2 software.

RESULTS

A total of 10160 patients were enrolled in 15 RCTs, including 5211 patients in the TBI/CY group and 4949 patients in the BU/CY group. Meta-analysis showed that there was a statistical difference in transplant failure rate (OR = 1.56, 95% CI (1.23, 1.97),  = 0.0002,  = 56%,  = 3.69), transplant mortality (OR = 1.45, 95% CI (1.24, 1.68),  < 0.00001,  = 76%,  = 4.80), transplantation long-term disease-free survival rate (OR = 1.52, 95% CI (1.09, 2.12),  = 0.01,  = 0%,  = 2.50), and transplantation adverse reactions (OR = 1.28, 95% CI (1.08, 1.52),  = 0.004,  = 0%,  = 2.85).

CONCLUSION

Meta-analysis showed that TBI/CY combined pretreatment regimen was more effective than BU/CY regimen alone in the treatment of pediatric hematologic transplantation, with a lower incidence of adverse reactions and significant long-term survival efficacy.

摘要

目的

观察全身照射加环磷酰胺（TBI/CY）与白消安加环磷酰胺（BU/CY）治疗小儿造血干细胞移植的疗效及不良反应发生率。

方法

通过检索 Cochrane 图书馆、PubMed、Web of Knowledge、Embase、中国生物医学文献数据库（CBM），筛选出随机对照试验（RCT），对纳入文献进行质量评价和数据提取，采用 Review Manager 5.2 软件对 RCT 进行 meta 分析。

结果

共纳入 15 项 RCT 共 10160 例患者，TBI/CY 组 5211 例，BU/CY 组 4949 例。Meta 分析显示，移植失败率（OR=1.56，95%CI（1.23，1.97），  = 0.0002，  = 56%，  = 3.69）、移植死亡率（OR=1.45，95%CI（1.24，1.68），  < 0.00001，  = 76%，  = 4.80）、移植后长期无病生存率（OR=1.52，95%CI（1.09，2.12），  = 0.01，  = 0%，  = 2.50）和移植不良反应发生率（OR=1.28，95%CI（1.08，1.52），  = 0.004，  = 0%，  = 2.85）差异均有统计学意义。

结论

Meta 分析表明，TBI/CY 预处理方案联合治疗小儿血液系统移植的疗效优于 BU/CY 单药方案，不良反应发生率较低，且具有显著的长期生存疗效。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/d638c848598a/JHE2022-2825712.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/f02d16de1ab3/JHE2022-2825712.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/439144394a17/JHE2022-2825712.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/0e202742c7f0/JHE2022-2825712.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/420157315b6e/JHE2022-2825712.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/0191b1144bfa/JHE2022-2825712.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/feed8fc4669f/JHE2022-2825712.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/d638c848598a/JHE2022-2825712.007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/f02d16de1ab3/JHE2022-2825712.001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/439144394a17/JHE2022-2825712.002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/0e202742c7f0/JHE2022-2825712.003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/420157315b6e/JHE2022-2825712.004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/0191b1144bfa/JHE2022-2825712.005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/feed8fc4669f/JHE2022-2825712.006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fe2/8956434/d638c848598a/JHE2022-2825712.007.jpg

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