目的:化疗和造血干细胞移植(HSCT)在临床病因、症状,标志,影像学发现,和生化参数在小儿肿瘤疾病中诱发可逆性后部脑病综合征(PRES)。我们旨在评估进行化疗和HSCT后小儿肿瘤疾病的各种危险因素,以诱导PRES来预测临床预后频率。方法:文献在PubMed上进行,WebofScience,和Embase数据库来识别合格的研究。使用相关危险因素的比值比(OR)及其相应的95%置信区间(CI)来计算结果的汇总评估。结果:六项研究纳入荟萃分析,涉及828条记录.在PRES的肿瘤年龄组中,女性儿童的风险发生率明显高于男性儿童。肿瘤年龄组中10岁以上的儿童发生PRES的风险显着增加。急性移植物抗宿主病(GVHD)对PRES的发生有显著的促进作用。高血压可促进儿童PRES的发生。免疫缺陷儿童的PRES风险显著增加。患有镰状细胞病(SCD)的儿童患PRES的风险显着增加。T细胞白血病患儿发生PRES的风险显著上升。中枢神经系统(CNS)白血病/受累在儿童PRES的发生中具有重要的促进作用。男性因素的合并OR,年龄≥10岁,急性GVHD,高血压,免疫缺陷,SCD,T细胞白血病,中枢神经系统白血病/受累为0.66(95%CI:0.58,0.76;P<0.00001),2.06(95%CI:1.23,3.43;P<0.006),1.32(95%CI:1.14,1.53;P<0.0003),8.84(95%CI:7.57,10.32;P<0.00001),2.72(95%CI:1.81,4.08;P<0.00001),2.87(95%CI:2.15,3.83;P<0.00001),2.84(95%CI:1.65,4.88;P<0.0002),和3.13(95%CI:1.43,6.84;P<0.004),分别。结论:这项荟萃分析的结果表明,女童,年龄超过10岁,急性GVHD,高血压,免疫缺陷,SCD,T细胞白血病,和中枢神经系统白血病/受累可能在PRES的儿科肿瘤/血液系统疾病中预后不良。
Objective: Chemotherapy and hematopoietic stem cell transplantation (HSCT) play important roles in clinical etiology, symptoms, signs, imaging findings, and biochemical parameters for inducing posterior reversible encephalopathy syndrome (PRES) in pediatric oncologic diseases. We aimed to evaluate various risk factors of pediatric oncologic diseases after conducting chemotherapy and HSCT to induce PRES for predicting the clinical prognosis frequency. Methods: The literature was performed on PubMed, Web of Science, and Embase databases to recognize the qualified studies. The odds ratios (ORs) of related risk factors and their corresponding 95% confidence intervals (CIs) were used to compute the pooled assessments of the outcomes. Results: Six studies were included in the meta-analysis, involving 828 records. The risk of female children has a significantly higher incidence than male children in oncologic age groups of PRES. Children over the age of 10 years old in oncologic age groups develop a significantly increased risk of PRES. Acute graft-versus-host disease (GVHD) has a significant promotion effect on the occurrence of PRES. Hypertension can promote the occurrence of PRES in children. The risk of PRES in immunodeficient children increases significantly. Children with sickle cell disease (SCD) have a significantly increased risk of PRES. The risk of PRES in children with T-cell leukemia rises considerably. The central nervous system (CNS) leukemia/involvement has a significant role in promoting the occurrence of PRES in children. The pooled OR for the factors male, ≥ 10 years old of age, acute GVHD, hypertension, immunodeficiency, SCD, T-cell leukemia, CNS leukemia/involvement was 0.66 (95% CI: 0.58, 0.76; P < 0.00001), 2.06 (95% CI: 1.23, 3.43; P < 0.006), 1.32 (95% CI: 1.14, 1.53; P < 0.0003), 8.84 (95% CI: 7.57, 10.32; P < 0.00001), 2.72 (95% CI: 1.81, 4.08; P < 0.00001), 2.87 (95% CI: 2.15, 3.83; P < 0.00001), 2.84 (95% CI: 1.65, 4.88; P < 0.0002), and 3.13 (95% CI: 1.43, 6.84; P < 0.004), respectively. Conclusions: The result of this meta-analysis suggests that female children, age over 10 years old, acute GVHD, hypertension, immunodeficiency, SCD, T-cell leukemia, and CNS leukemia/involvement are likely to have the poor outcome in pediatric oncologic/hematologic diseases in PRES.