背景:接受造血干细胞移植(HSCT)的儿童出血性膀胱炎(HC)的危险因素尚不清楚。因此,我们进行了系统评价和荟萃分析,以调查接受HSCT的儿童发生HC的危险因素.
方法:我们通过检索PubMed,EMBASE,和Cochrane图书馆截至2023年10月10日,并分析那些符合纳入标准的。I2统计量用于评价异质性。
结果:12项研究,包括2764名病人,进行了分析。男性(优势比[OR]=1.52;95%置信区间[CI],1.16-2.00;p=0.003,I2=0%),同种异体供体(OR=5.28;95%CI,2.60-10.74;p<0.00001,I2=0%),人类白细胞抗原(HLA)错配供体(OR=1.86;95%CI,1.00-3.44;p=0.05,I2=31%),无关供体(OR=1.58;95%CI,1.10-2.28;p=0.01,I2=1%),清髓性条件(MAC)(OR=3.17;95%CI,1.26-7.97;p=0.01,I2=0%),白消安(OR=2.18;95%CI,1.33-3.58;p=0.002,I2=0%)或抗胸腺球蛋白(OR=1.65;95%CI,1.07-2.54;p=0.02,I2=16%)使用,巨细胞病毒(CMV)再激活(OR=2.64;95%CI,1.44-4.82;p=0.002,I2=0%)是接受HSCT的儿童HC的危险因素。
结论:男性,同种异体供体,HLA不匹配,无关的捐赠者,MAC,使用白消安或抗胸腺球蛋白,CMV再激活是HSCT患儿发生HC的危险因素。
BACKGROUND: The risk factors for hemorrhagic cystitis (HC) in children undergoing hematopoietic stem cell transplantation (HSCT) are unclear. Therefore, we conducted this systematic
review and meta-analysis to investigate the risk factors for HC in children undergoing HSCT.
METHODS: We performed this meta-analysis by retrieving studies from PubMed, EMBASE, and the Cochrane Library up to October 10, 2023, and analyzing those that met the inclusion criteria. I2 statistics were used to evaluate heterogeneity.
RESULTS: Twelve studies, including 2,764 patients, were analyzed. Male sex (odds ratio [OR] = 1.52; 95% confidence interval [CI], 1.16-2.00; p = 0.003, I2 = 0%), allogeneic donor (OR = 5.28; 95% CI, 2.60-10.74; p < 0.00001, I2 = 0%), human leukocyte antigen (HLA) mismatched donor (OR = 1.86; 95% CI, 1.00-3.44; p = 0.05, I2 = 31%), unrelated donor (OR = 1.58; 95% CI, 1.10-2.28; p = 0.01, I2 = 1%), myeloablative conditioning (MAC) (OR = 3.17; 95% CI, 1.26-7.97; p = 0.01, I2 = 0%), busulfan (OR = 2.18; 95% CI, 1.33-3.58; p = 0.002, I2 = 0%) or anti-thymoglobulin (OR = 1.65; 95% CI, 1.07-2.54; p = 0.02, I2 = 16%) use, and cytomegalovirus (CMV) reactivation (OR = 2.64; 95% CI, 1.44-4.82; p = 0.002, I2 = 0%) were risk factors for HC in children undergoing HSCT.
CONCLUSIONS: Male sex, allogeneic donor, HLA-mismatched, unrelated donor, MAC, use of busulfan or anti-thymoglobulin, and CMV reactivation are risk factors for HC in children undergoing HSCT.