Bone marrow versus peripheral blood as a graft source for haploidentical donor transplantation in adults using post-transplant cyclophosphamide-A systematic review and meta-analysis
机构:[a]Department of Pharmacy, Peking University People's Hospital, Beijing, 100044, China[b]Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China[c]Department of Scientific Research, Peking University People's Hospital, Beijing, 100044, China[d]Peking University First Hospital, Beijing, 100034, China[e]Department of Pharmacy, Beijing Children’s Hospital Affiliated to Capital University of Medical Sciences, Beijing, 100045, China医技科室药学部首都医科大学附属北京儿童医院[f]Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, China内科系统血液科浙江大学医学院附属第一医院
Background: Peripheral-blood (PB) and bone marrow (BM) are both widely used in hematopoietic stem cell transplantation (HSCT). However, it is unclear whether PB or BM produces a more satisfactory outcome in haploidentical HSCT, particularly for patients using post-transplant cyclophosphamide (PTCy), which is the standard therapy. However, to date, no meta-analysis focusing on this issue has been published. Methods: We systematically. searched PubMed, MEDLINE, Web of Science, the Cochrane Library and the ClinicalTrials.gov website for studies regarding the use of BM or PB in haploidentical HSCT for hematological malignancies in adults using PTCy. Data were analyzed using Open Meta-Analyst statistical software. Results: Fourteen studies were extracted including four comparative retrospective reports and ten single-arm reports, with a total of 1759 patients received PTCy haploidentical HSCT (462 patients received PBSCT, 1297 patients received BMT). The pooled outcomes of comparative retrospective studies showed significantly higher incidence of grade III-IV acute graft-versus-host disease (GVHD) (OR = 1.741, 95%CI 1.032-2.938), incidence of grade II-IV acute GVHD (OR = 1.778, 95%CI 1.314, 2.406) and engraftment rate (OR = 1.843, 95%CI 1.066-3.185) in the PB group. No significant differences were found on the incidence of relapse, 2-year overall survival (OS) and disease-free survival (DFS), acute II-IV GVHD and chronic GVHD between PBSCT or BMT. Conclusion: The efficacy of PB is not inferior to BM for patients undergoing PTCy haploidentical HSCT with regard to primary outcomes, including OS, DFS, NRM and relapse. However, with regards to convenience and pain relief, PB graft is suitable for haploidentical HSCT, but with a higher risk of acute GVHD.
基金:
National Key R&D Program of China [2016YFE0202800, 2016YFC0902803]; National Natural Science Foundation of ChinaNational Natural Science Foundation of China [81570128]
第一作者机构:[a]Department of Pharmacy, Peking University People's Hospital, Beijing, 100044, China[b]Department of Pharmacy Administration and Clinical Pharmacy, School of Pharmaceutical Sciences, Peking University, Beijing, 100191, China
共同第一作者:
通讯作者:
通讯机构:[a]Department of Pharmacy, Peking University People's Hospital, Beijing, 100044, China[f]Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, China[*1]Department of Pharmacy, Peking University People's Hospital, China.[*2]Department of Hematology& Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, Chin
推荐引用方式(GB/T 7714):
Xiaotong Yu,Liping Liu,Zhenwei Xie,et al.Bone marrow versus peripheral blood as a graft source for haploidentical donor transplantation in adults using post-transplant cyclophosphamide-A systematic review and meta-analysis[J].CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY.2019,133:120-128.doi:10.1016/j.critrevonc.2018.05.017.
APA:
Xiaotong Yu,Liping Liu,Zhenwei Xie,Chongya Dong,Libo Zhao...&Hong-Hu Zhu.(2019).Bone marrow versus peripheral blood as a graft source for haploidentical donor transplantation in adults using post-transplant cyclophosphamide-A systematic review and meta-analysis.CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY,133,
MLA:
Xiaotong Yu,et al."Bone marrow versus peripheral blood as a graft source for haploidentical donor transplantation in adults using post-transplant cyclophosphamide-A systematic review and meta-analysis".CRITICAL REVIEWS IN ONCOLOGY HEMATOLOGY 133.(2019):120-128