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Efficacy of Allogeneic Hematopoietic Stem Cell Transplantation in Intermediate-Risk Acute Myeloid Leukemia Adult Patients in First Complete Remission: A Meta-Analysis of Prospective Studies
Li, Dandan1,2; Wang, Li1,2; Zhu, Honghu3; Dou, Liping1; Liu, Daihong1; Fu, Lin4; Ma, Cong5; Ma, Xuebin6; Yao, Yushi1; Zhou, Lei1,7; Wang, Qian1; Wang, Lijun1; Zhao, Yu1; Jing, Yu1; Wang, Lili1; Li, Yonghui1; Yu, Li1
刊名PLOS ONE
2015-07-21
DOI10.1371/journal.pone.0132620
10期:7
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Multidisciplinary Sciences
研究领域[WOS]Science & Technology - Other Topics
关键词[WOS]BONE-MARROW-TRANSPLANTATION ; ACUTE MYELOGENOUS LEUKEMIA ; HIGH-DOSE CYTARABINE ; PROSPECTIVE CONTROLLED-TRIAL ; PROSPECTIVE MULTICENTER TRIAL ; VERSUS-HOST-DISEASE ; POSTREMISSION THERAPY ; INTENSIFICATION CHEMOTHERAPY ; CONSOLIDATION CHEMOTHERAPY ; INTENSIVE CHEMOTHERAPY
英文摘要

Hematopoietic stem cell transplantation (HSCT) and consolidation chemotherapy have been used to treat intermediate-risk acute myeloid leukemia (AML) patients in first complete remission (CR1). However, it is still unclear which treatments are most effective for these patients. The aim of our study was to analyze the relapse-free survival (RFS) and overall survival (OS) benefit of allogeneic HSCT (alloHSCT) for intermediate-risk AML patients in CR1. A meta-analysis of prospective trials comparing alloHSCT to non-alloHSCT (autologous HSCT [autoHSCT] and/or chemotherapy) was undertaken. We systematically searched PubMed, Embase, and the Cochrane Library though October 2014, using keywords and relative MeSH or Emtree terms, ′allogeneic′; ′acut*′ and ′leukem*/aml/leukaem*/ leucem*/leucaem*′; and ′nonlympho*′ or ′myelo*′. A total of 7053 articles were accessed. The primary outcomes were RFS and OS, while the secondary outcomes were treatment-related mortality (TRM) and relapse rate (RR). Hazard ratios (HR) and 95% confidence intervals (CI) were calculated for each outcome. The primary outcomes were RFS and OS, while the secondary outcomes were TRM and RR. We included 9 prospective controlled studies including 1950 adult patients. Patients with intermediate-risk AML in CR1 who received either alloHSCT or non-alloHSCT were considered eligible. AlloHSCT was found to be associated with significantly better RFS, OS, and RR than non-alloHSCT (HR, 0.684 [95% CI: 0.48, 0.95]; HR, 0.76 [95% CI: 0.61, 0.95]; and HR, 0.58 [95% CI: 0.45, 0.75], respectively). TRM was significantly higher following alloHSCT than non-alloHSCT (HR, 3.09 [95% CI: 1.38, 6.92]). However, subgroup analysis showed no OS benefit for alloHSCT over autoHSCT (HR, 0.99 [95% CI: 0.70, 1.39]). In conclusion, alloHSCT is associated with more favorable RFS, OS, and RR benefits (but not TRM outcomes) than non-alloHSCT generally, but does not have an OS advantage over autoHSCT specifically, in patients with intermediate-risk AML in CR1.

语种英语
WOS记录号WOS:000358547600044
引用统计
被引频次:4[WOS]   [WOS记录]     [WOS相关记录]
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/57157
专题北京大学第二临床医学院_血液科
北京大学第三临床医学院_血液内科
作者单位1.Chinese Peoples Liberat Army Gen Hosp, Dept Hematol, Beijing, Peoples R China
2.Med Coll Chinese PLA, Beijing, Peoples R China
3.Peking Univ, Inst Hematol, Peoples Hosp, Dept Hematol, Beijing 100871, Peoples R China
4.Peking Univ, Hosp 3, Dept Hematol, Beijing 100871, Peoples R China
5.PLA Navy Gen Hosp, Dept Clin Lab, Beijing, Peoples R China
6.PLA Navy Gen Hosp, Tumor Diag & Treatment Ctr, Beijing, Peoples R China
7.202 Hosp PLA, Dept Hematol, Shenyang, Peoples R China
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GB/T 7714
Li, Dandan,Wang, Li,Zhu, Honghu,et al. Efficacy of Allogeneic Hematopoietic Stem Cell Transplantation in Intermediate-Risk Acute Myeloid Leukemia Adult Patients in First Complete Remission: A Meta-Analysis of Prospective Studies[J]. PLOS ONE,2015,10(7).
APA Li, Dandan.,Wang, Li.,Zhu, Honghu.,Dou, Liping.,Liu, Daihong.,...&Yu, Li.(2015).Efficacy of Allogeneic Hematopoietic Stem Cell Transplantation in Intermediate-Risk Acute Myeloid Leukemia Adult Patients in First Complete Remission: A Meta-Analysis of Prospective Studies.PLOS ONE,10(7).
MLA Li, Dandan,et al."Efficacy of Allogeneic Hematopoietic Stem Cell Transplantation in Intermediate-Risk Acute Myeloid Leukemia Adult Patients in First Complete Remission: A Meta-Analysis of Prospective Studies".PLOS ONE 10.7(2015).
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