PDF(Pubmed)
Abstract：
UNASSIGNED: Hematopoietic stem cell transplantation (HSCT) is an effective treatment for aplastic anemia. Recently, peripheral blood stem cell transplantation (PBSCT) has gradually replaced traditional bone marrow transplantation (BMT). However, which graft source has a better therapeutic effect and prognosis for aplastic anemia (AA) remains unclear. Therefore, we conducted this systematic review and meta-analysis.
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.
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.
摘要：
■造血干细胞移植（HSCT）是再生障碍性贫血的有效治疗方法。最近,外周血干细胞移植(PBSCT)逐渐取代传统的骨髓移植(BMT)。然而,再生障碍性贫血(AA)治疗效果较好,预后尚不清楚。因此,我们进行了系统综述和荟萃分析.
■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。
■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。
