UNASSIGNED: We systematically searched PubMed, EMBASE, and the Cochrane Library without language limitations for studies using PBSCT or BMT for AA. Data were analyzed using the Open Meta-Analyst.
UNASSIGNED: We identified 17 of 18,749 studies, including seven comparative reports and nine single-arm reports, with a total of 3,516 patients receiving HSCT (1,328 and 2,188 patients received PBSCT and BMT, respectively). The outcomes of the comparative studies showed similar 5-year overall survival [OS; relative risk (RR) = 0.867; 95% confidence interval (CI), 0.747-1.006], similar transplant-related mortality (RR = 1.300; 95%CI, 0.790-2.138), graft failure rate (RR = 0.972; 95%CI, 0.689-1.372) between the PBSCT group and the BMT group, while the PBSCT group had a significantly higher incidence of chronic graft-versus-host disease (GVHD; RR = 1.796; 95% CI, 1.571-2.053) and a higher incidence of grade IV acute GVHD (RR = 1.560; 95% CI, 1.341-1.816) compared to the BMT group. The outcomes of single-arm reports showed similar 3-year OS and incidences of chronic GVHD, acute II-IV GVHD, III-IV GVHD, transplant-related mortality and graft failure rate between PBSCT and BMT.
UNASSIGNED: Before 2010, PBSCT was not superior to BMT in terms of 5-year OS, transplant-related mortality and graft failure rate, but it exhibited a higher risk of both chronic and acute GVHD. After 2010, PBSCT and BMT showed similar 3-year OS, GVHD risks, transplant-related mortality and graft failure rate. PB grafts are more suitable for HSCT of the AA for convenience and pain relief.
UNASSIGNED: www.crd.york.ac.uk/PROSPERO/, CRD42023412467.
■我们系统地搜索了PubMed,EMBASE,和Cochrane图书馆没有语言限制,可以使用PBSCT或BMT进行AA研究。使用开放元分析师分析数据。
■我们确定了18,749项研究中的17项,包括七份比较报告和九份单臂报告,共有3,516例患者接受HSCT(1,328例和2,188例患者接受PBSCT和BMT,分别)。比较研究的结果显示5年总生存期相似[OS;相对风险(RR)=0.867;95%置信区间(CI),0.747-1.006],与移植相关的死亡率相似(RR=1.300;95CI,0.790-2.138),PBSCT组和BMT组之间的移植物失败率(RR=0.972;95CI,0.689-1.372),而与BMT组相比,PBSCT组慢性移植物抗宿主病(GVHD;RR=1.796;95%CI,1.571~2.053)的发生率明显较高,IV级急性GVHD的发生率较高(RR=1.560;95%CI,1.341~1.816).单臂报告的结果显示,3年OS和慢性GVHD的发病率相似,急性II-IVGVHD,III-IVGVHD,PBSCT和BMT之间的移植相关死亡率和移植物失败率。
■在2010年之前,PBSCT在5年OS方面并不优于BMT,移植相关死亡率和移植物失败率,但它表现出慢性和急性GVHD的高风险。2010年后,PBSCT和BMT显示出相似的3年操作系统,GVHD风险,移植相关死亡率和移植物失败率。PB移植物更适合于AA的HSCT,以方便和缓解疼痛。
■www.crd.约克。AC.英国/PROSPERO/,CRD42023412467。