Maurya Shailendra Shanker, Sagar Nitin, Chaturvedi Sumit, Pandey Maneesha, Kushwaha Sapana, Kashyap Rajesh
Stem Cell Research Center, Department of Hematology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India.
Department of Biophysics, University of Delhi South Campus, New Delhi, India.
Front Transplant. 2025 Jun 5;4:1551820. doi: 10.3389/frtra.2025.1551820. eCollection 2025.
Hematopoietic stem cell transplantation (HSCT) is a significant treatment option for acute myeloid leukemia (AML). However, some important questions remain related to its efficacy and safety, specifically when administered to various age cohorts among pediatric and adult patients.
This study aimed to investigate the efficacy of HSCT in treating pediatric patients compared to adult patients diagnosed with AML.
A systematic search was conducted in PubMed, Scopus, Google Scholar, and Medline for studies published in the English language from inception to 2023. The findings were reported using the PRISMA checklist. Statistical analysis was conducted using Cochrane's software (Rev Man) version 5.4, which used random and fixed effect models when necessary.
In total, 14 studies met the criteria for meta-analysis. The results indicated a slightly positive trend in overall survival in the pediatric and combined pediatric-adult groups compared to adults alone, although the differences were not statistically significant. For relapse rate, no significant differences were observed in the adult and pediatric groups individually, while the combined pediatric-adult group showed a substantial benefit from HSCT (OR: 2.3, -value: -0.05). A similar trend was observed in disease-free survival, where the combined group showed a modest, though not statistically significant, improvement with HSCT. Furthermore, regarding treatment-related mortality, a statistically protective effect of HSCT was observed in the adult group (OR: 0.26, = 0.0005), while the pediatric and combined groups did not show significant effects. For graft-vs.-host disease, a significant association with HSCT was found in the pediatric group (OR: 2.58, = 0.03), while the adult and combined groups showed no significant effects.
Our analysis showed mixed results, showing a slightly better effect of HSCT in treating pediatric patients diagnosed with AML compared to adult patients.
造血干细胞移植（HSCT）是急性髓系白血病（AML）的一种重要治疗选择。然而，关于其疗效和安全性仍存在一些重要问题，特别是在儿科和成人患者的不同年龄组中应用时。
本研究旨在调查与诊断为AML的成人患者相比，HSCT治疗儿科患者的疗效。
在PubMed、Scopus、谷歌学术和Medline中进行系统检索，以查找从创刊到2023年以英文发表的研究。研究结果使用PRISMA清单进行报告。使用Cochrane软件（Rev Man）5.4版进行统计分析，必要时使用随机和固定效应模型。
共有14项研究符合荟萃分析标准。结果表明，与单独的成人组相比，儿科组以及儿科与成人联合组的总生存率呈略微积极的趋势，尽管差异无统计学意义。对于复发率，成人组和儿科组各自均未观察到显著差异，而儿科与成人联合组显示HSCT带来显著益处（OR：2.3，P值：-0.05）。在无病生存率方面观察到类似趋势，联合组显示HSCT有适度改善，但无统计学意义。此外，关于治疗相关死亡率，在成人组中观察到HSCT具有统计学保护作用（OR：0.26，P = 0.0005），而儿科组和联合组未显示显著影响。对于移植物抗宿主病，在儿科组中发现与HSCT有显著关联（OR：2.58，P = 0.03），而成人组和联合组未显示显著影响。
我们的分析结果不一，表明与成人患者相比，HSCT在治疗诊断为AML的儿科患者方面效果略好。
