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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

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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 [f]Department of Hematology & Institute of Hematology, The First Affiliated Hospital, Zhejiang University, Hangzhou, 310003, China
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关键词: Peripheral blood Bone marrow Hematopoietic haploidentical transplantation stem cell transplantation Adults Post-transplant cyclophosphamide

摘要:
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.

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出版当年[2018]版
大类 | 2 区 医学
小类 | 3 区 血液学 3 区 肿瘤学
最新[2023]版
大类 | 2 区 医学
小类 | 2 区 血液学 2 区 肿瘤学
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出版当年[2017]版:
Q1 HEMATOLOGY Q2 ONCOLOGY
最新[2023]版:
Q1 HEMATOLOGY Q1 ONCOLOGY

影响因子: 最新[2023版] 最新五年平均 出版当年[2017版] 出版当年五年平均 出版前一年[2016版] 出版后一年[2018版]

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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
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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
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