HLA 单倍体相合与同胞相合造血细胞移植：系统评价和荟萃分析。
HLA-haploidentical vs matched-sibling hematopoietic cell transplantation: a systematic review and meta-analysis.
机构信息
Division of Hematology, Oncology, and Transplantation, Department of Medicine, and.
Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN.
出版信息
Blood Adv. 2019 Sep 10;3(17):2581-2585. doi: 10.1182/bloodadvances.2019000614.
Abstract
HLA haploidentical hematopoietic cell transplantation (haplo-HCT) using posttransplantation cyclophosphamide (PT-Cy) is an alternative strategy when a matched sibling donor (MSD) is not available. We performed a systematic review and meta-analysis to compare the outcomes of MSD vs haplo-HCT. Eleven studies (1410 haplo-HCT and 6396 MSD recipients) were meta-analyzed. All studies were retrospective and high quality, and 9 were multicenter. Haplo-HCT was associated with ~50% lower risk of chronic graft-versus-host disease (GVHD) (hazard ratio [HR], 0.55; 95% confidence interval [CI], 0.41-0.74), but higher risk of nonrelapse mortality (HR, 1.36; 95% CI, 1.12-1.66). Relapse, survival, acute GVHD, and GVHD-free relapse-free survival were not significantly different between the groups. Deciphering the relative contribution of PT-Cy and HLA disparity to the observed outcome differences between the groups requires further research.
摘要
HLA 单倍体相合造血细胞移植（haplo-HCT）联合移植后环磷酰胺（PT-Cy）是在没有匹配同胞供者（MSD）时的替代策略。我们进行了系统评价和荟萃分析，以比较 MSD 与 haplo-HCT 的结果。共有 11 项研究（1410 例 haplo-HCT 和 6396 例 MSD 受者）进行了荟萃分析。所有研究均为回顾性且质量较高，其中 9 项为多中心研究。haplo-HCT 与慢性移植物抗宿主病（GVHD）的风险降低约 50%相关（风险比 [HR]，0.55；95%置信区间 [CI]，0.41-0.74），但非复发死亡率的风险升高（HR，1.36；95%CI，1.12-1.66）。两组间的复发、生存、急性 GVHD 和无 GVHD 无复发生存率无显著差异。需要进一步研究来阐明 PT-Cy 和 HLA 错配对两组间观察到的结果差异的相对贡献。
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