Comparison of Allogeneic Stem Cell Transplant and Autologous Stem Cell Transplant in Refractory or Relapsed Peripheral T-Cell Lymphoma: A Systematic Review and Meta-analysis.
Comparison of Allogeneic Stem Cell Transplant and Autologous Stem Cell Transplant in Refractory or Relapsed Peripheral T-Cell Lymphoma: A Systematic Review and Meta-analysis.
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DOI：
10.1001/jamanetworkopen.2021.9807
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发表时间：
2021-05-03
影响因子：
13.8
通讯作者：
Huang Z
中科院分区：
文献类型：
--
作者：
Du J;Yu D;Han X;Zhu L;Huang Z
对于难治性或复发性外周T细胞淋巴瘤患者，异基因造血干细胞移植（HSCT）或自体HSCT更有效、更安全？在这项对30项试验（1765例患者）进行的系统性综述和荟萃分析中，对于接受同种异体HSCT的患者，3年总生存率为50%，3年无进展生存率为42%，3年移植相关死亡率为32%。对于接受自体HSCT的患者，3年总生存率为55%，3年无进展生存率为41%，3年移植相关死亡率为7%。这些结果表明，同种异体HSCT可能有更好的疗效，但安全性低于自体HSCT的患者难治性或复发性外周T细胞淋巴瘤。造血干细胞移植（HSCT）是治疗难治性或复发性外周T细胞淋巴瘤（R/R-PTCL）的一种可取选择，但异基因HSCT或自体HSCT是否更有益尚不清楚。比较同种异体HSCT与自体HSCT在R/R-PTCL患者中的有效性和安全性。对PubMed、Embase、科克伦对照试验中心数据库、万方数据库和中国知网数据库进行了系统检索，检索项为难治性或复发性外周T细胞淋巴瘤、ASCT/自体干细胞移植、allo-HSCT/异基因干细胞移植、治疗效果和治疗，检索时间为2001年1月12日至10月1日。2020.在排除重复和不相关的文献后，根据纳入标准（临床试验或回顾性研究，>10个样本）和排除标准（没有总生存期[OS]，无进展生存期[PFS]和移植相关死亡率[TRM]的文章），329篇不合格。30项试验被纳入荟萃分析。本研究遵循系统性综述和荟萃分析（PRISMA）报告指南的首选报告项目。提取了研究设计、个体特征和结局的数据。通过应用随机效应模型合并所有统计量。预先规定的主要结局为OS、PFS和TRM。在6548篇文献中，从30项研究（包括880例接受同种异体HSCT的患者和885例接受自体HSCT的患者）中提取的数据被纳入本荟萃分析。在同种异体HSCT组中，3年OS为50%，（95% CI，41%-60%），PFS为42%（95% CI，35%-51%），5年OS为54%（95% CI，47%-62%），PFS为48%（95% CI，40%-56%），3年TRM为32%（95% CI，27%-37%）。在自体HSCT组中，3年OS为55%，（95% CI，48%-64%），PFS为41%（95% CI，33%-51%），5年OS为53%（95% CI，44%-64%），PFS为40%（95% CI，24%-58%），3年TRM为7%（95% CI，2%-23%）。在这项系统性综述和荟萃分析中，同种异体HSCT和自体HSCT组的OS和PFS相似;然而，同种异体HSCT与R/R-PTCL患者的特定生存获益相关。本荟萃分析比较了异基因与自体造血干细胞移植治疗难治性或复发性外周T细胞淋巴瘤患者的有效性和安全性。
Is allogeneic hematopoietic stem cell transplant (HSCT) or autologous HSCT more effective and safer for patients with refractory or relapsed peripheral T-cell lymphoma? In this systematic review and meta-analysis of 30 trials with 1765 patients, for patients undergoing allogeneic HSCT, the 3-year overall survival was 50%, the 3-year progression-free survival was 42%, and the 3-year transplant-related mortality was 32%. For patients undergoing autologous HSCT, the 3-year overall survival was 55%, the 3-year progression-free survival was 41%, and the 3-year transplant-related mortality was 7%. These findings suggest that allogeneic HSCT may have better effectiveness but be less safe than autologous HSCT for patients with refractory or relapsed peripheral T-cell lymphoma. Hematopoietic stem cell transplant (HSCT) is an advisable option for refractory or relapsed peripheral T-cell lymphoma (R/R-PTCL), but whether allogeneic HSCT or autologous HSCT is more beneficial is unknown. To compare the effectiveness and safety of allogeneic HSCT vs autologous HSCT in patients with R/R-PTCL. A systematic search of the PubMed, Embase, the Cochrane Central Register of Controlled Trials, Wanfang, and China National Knowledge Infrastructure databases with the search items refractory or relapsed peripheral T-cell lymphoma, ASCT/autologous stem-cell transplantation, allo-HSCT/allogeneic stem-cell transplantation, therapeutic effect, and treatment was conducted for articles published from January 12, 2001, to October 1, 2020. After duplicate and irrelevant publications were discarded, 329 were ineligible according to the inclusion (clinical trials or retrospective studies with >10 samples) and exclusion criteria (articles without overall survival [OS], progression-free survival [PFS], and transplantation-related mortality [TRM]). Thirty trials were included in the meta-analysis. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) reporting guideline. Data on study design, individual characteristics, and outcomes were extracted. All statistics were pooled by applying a random-effects model. The prespecified main outcomes were OS, PFS, and TRM. Of 6548 articles, data extracted from the 30 studies (including 880 patients who underwent allogeneic HSCT and 885 who underwent autologous HSCT) were included in this meta-analysis. In the allogeneic HSCT group, a 3-year OS of 50% (95% CI, 41%-60%) and PFS of 42% (95% CI, 35%-51%), a 5-year OS of 54% (95% CI, 47%-62%) and PFS of 48% (95% CI, 40%-56%), and a 3-year TRM of 32% (95% CI, 27%-37%) were observed. In the autologous HSCT group, a 3-year OS of 55% (95% CI, 48%-64%) and PFS of 41% (95% CI, 33%-51%), a 5-year OS of 53% (95% CI, 44%-64%) and PFS of 40% (95% CI, 24%-58%), and a 3-year TRM of 7% (95% CI, 2%-23%) were observed. In this systematic review and meta-analysis, OS and PFS were similar in the allogeneic HSCT and autologous HSCT groups; however, allogeneic HSCT was associated with specific survival benefits among patients with R/R-PTCL. This meta-analysis compares the effectiveness and safety of allogeneic vs autologous hematopoietic stem cell transplant in patients with refractory or relapsed peripheral T-cell lymphoma.
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影响因子：
4.3
作者：
Chen, Andy I.;McMillan, Alex;Neprin, Robert S.;Horning, Sandra J.;Laport, Ginna G.
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作者：
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