HLA-haploidentical vs matched-sibling hematopoietic cell transplantation: a systematic review and meta-analysis.
HLA-haploidentical vs matched-sibling hematopoietic cell transplantation: a systematic review and meta-analysis.
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DOI：
10.1182/bloodadvances.2019000614
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发表时间：
2019-09-10
期刊：
影响因子：
7.5
通讯作者：
Rashidi, Armin
中科院分区：
文献类型：
--
作者：
Meybodi, Mohamad A;Cao, Wenhao;Rashidi, Armin
当没有匹配的同胞供体 (MSD) 时，使用移植后环磷酰胺 (PT-Cy) 的 HLA 单倍相合造血细胞移植 (haplo-HCT) 是一种替代策略。我们进行了系统回顾和荟萃分析，以比较 MSD 与 haplo-HCT 的结果。对 11 项研究（1410 名单倍体 HCT 和 6396 名 MSD 接受者）进行了荟萃分析。所有研究均为回顾性且高质量的研究，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%（风险比 [HR]，0.55；95% 置信区间 [CI]，0.41-0.74），但非复发死亡率风险较高（HR，1.36；95% CI，1.12-1.66）。两组之间的复发、生存、急性 GVHD 和无 GVHD 无复发生存没有显着差异。破译 PT-Cy 和 HLA 差异对观察到的组间结果差异的相对贡献需要进一步研究。
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.