Peter Olujimi Odutola , Peter Oluwatobi Olorunyomi , Ifeoluwapo Olorunyomi
{"title":"急性白血病的单脐血移植与双脐血移植：系统回顾和荟萃分析。","authors":"Peter Olujimi Odutola , Peter Oluwatobi Olorunyomi , Ifeoluwapo Olorunyomi","doi":"10.1016/j.leukres.2024.107517","DOIUrl":null,"url":null,"abstract":"<div><h3>Background and aims</h3><p>Umbilical cord blood transplantation (UCBT) has emerged as a promising treatment option for patients with acute leukemia needing hematopoietic stem cell transplantation. Both single (sUCBT) and double cord blood units (dUCBT) demonstrate potential benefits, but studies comparing their effectiveness have shown mixed results. This meta-analysis aimed to determine the comparative safety and efficacy of sUCBT versus dUCBT in acute leukemia patients.</p></div><div><h3>Methods</h3><p>Electronic databases were systematically examined to identify relevant studies comparing single vs double UCBT published until November 2023. Nine studies involving 3864 acute leukemia patients undergoing UCBT were included. Outcomes analyzed were acute graft-versus-host disease (GVHD), chronic GVHD, relapse, non-relapse mortality, leukemia-free survival and overall survival. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random effects model.</p></div><div><h3>Results</h3><p>The risk of Grade II-IV acute GVHD (RR 1.55, 95% CI 1.19–2.03) and Grade III-IV acute GVHD (RR 1.25, 95% CI 1.07–1.46) were significantly higher with dUCBT. Relapse risk was lower with dUCBT (RR 0.57, 95% CI 0.38–0.88) while overall survival favored sUCBT (RR 1.25, 95% CI 1.06–1.46). No significant differences were observed for chronic GVHD, non-relapse mortality or leukemia-free survival.</p></div><div><h3>Conclusion</h3><p>Both single and double UCBT have potential as effective treatments for acute leukemia. The choice of treatment should consider various factors, including the risk of GVHD, relapse, and mortality. More research, especially randomized trials, is needed to provide definitive guidance on the optimal use of single and double unit UCBT in patients with acute leukemia.</p></div>","PeriodicalId":18051,"journal":{"name":"Leukemia research","volume":null,"pages":null},"PeriodicalIF":2.1000,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Single vs double umbilical cord blood transplantation in acute leukemia: Systematic review and meta-analysis\",\"authors\":\"Peter Olujimi Odutola , Peter Oluwatobi Olorunyomi , Ifeoluwapo Olorunyomi\",\"doi\":\"10.1016/j.leukres.2024.107517\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background and aims</h3><p>Umbilical cord blood transplantation (UCBT) has emerged as a promising treatment option for patients with acute leukemia needing hematopoietic stem cell transplantation. Both single (sUCBT) and double cord blood units (dUCBT) demonstrate potential benefits, but studies comparing their effectiveness have shown mixed results. This meta-analysis aimed to determine the comparative safety and efficacy of sUCBT versus dUCBT in acute leukemia patients.</p></div><div><h3>Methods</h3><p>Electronic databases were systematically examined to identify relevant studies comparing single vs double UCBT published until November 2023. Nine studies involving 3864 acute leukemia patients undergoing UCBT were included. Outcomes analyzed were acute graft-versus-host disease (GVHD), chronic GVHD, relapse, non-relapse mortality, leukemia-free survival and overall survival. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random effects model.</p></div><div><h3>Results</h3><p>The risk of Grade II-IV acute GVHD (RR 1.55, 95% CI 1.19–2.03) and Grade III-IV acute GVHD (RR 1.25, 95% CI 1.07–1.46) were significantly higher with dUCBT. Relapse risk was lower with dUCBT (RR 0.57, 95% CI 0.38–0.88) while overall survival favored sUCBT (RR 1.25, 95% CI 1.06–1.46). No significant differences were observed for chronic GVHD, non-relapse mortality or leukemia-free survival.</p></div><div><h3>Conclusion</h3><p>Both single and double UCBT have potential as effective treatments for acute leukemia. The choice of treatment should consider various factors, including the risk of GVHD, relapse, and mortality. More research, especially randomized trials, is needed to provide definitive guidance on the optimal use of single and double unit UCBT in patients with acute leukemia.</p></div>\",\"PeriodicalId\":18051,\"journal\":{\"name\":\"Leukemia research\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2024-05-15\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Leukemia research\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0145212624000833\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q3\",\"JCRName\":\"HEMATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Leukemia research","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0145212624000833","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"HEMATOLOGY","Score":null,"Total":0}
引用次数: 0
摘要
背景和目的：对于需要进行造血干细胞移植的急性白血病患者来说，脐带血移植（UCBT）已成为一种很有前景的治疗方案。单份脐带血（sUCBT）和双份脐带血（dUCBT）都显示出潜在的益处，但对其有效性进行比较的研究结果不一。这项荟萃分析旨在确定在急性白血病患者中sUCBT与dUCBT的安全性和有效性比较：对电子数据库进行了系统检查，以确定截至 2023 年 11 月发表的比较单 UCBT 与双 UCBT 的相关研究。共纳入九项研究，涉及接受 UCBT 的 3864 名急性白血病患者。分析的结果包括急性移植物抗宿主病（GVHD）、慢性GVHD、复发、非复发死亡率、无白血病生存期和总生存期。采用随机效应模型计算了汇总风险比（RR）及95%置信区间（CI）：结果：使用 dUCBT 后，II-IV 级急性 GVHD（RR 1.55，95% CI 1.19-2.03）和 III-IV 级急性 GVHD（RR 1.25，95% CI 1.07-1.46）的风险显著升高。dUCBT的复发风险较低（RR 0.57，95% CI 0.38-0.88），而sUCBT的总生存率更高（RR 1.25，95% CI 1.06-1.46）。在慢性GVHD、非复发死亡率或无白血病生存率方面未观察到明显差异：结论：单人和双人 UCBT 都有可能成为治疗急性白血病的有效方法。结论：单人和双人 UCBT 都有可能成为治疗急性白血病的有效方法，但在选择治疗方法时应考虑各种因素，包括 GVHD、复发和死亡率的风险。需要进行更多的研究，尤其是随机试验，为急性白血病患者最佳使用单、双单位 UCBT 提供明确的指导。
Single vs double umbilical cord blood transplantation in acute leukemia: Systematic review and meta-analysis
Background and aims
Umbilical cord blood transplantation (UCBT) has emerged as a promising treatment option for patients with acute leukemia needing hematopoietic stem cell transplantation. Both single (sUCBT) and double cord blood units (dUCBT) demonstrate potential benefits, but studies comparing their effectiveness have shown mixed results. This meta-analysis aimed to determine the comparative safety and efficacy of sUCBT versus dUCBT in acute leukemia patients.
Methods
Electronic databases were systematically examined to identify relevant studies comparing single vs double UCBT published until November 2023. Nine studies involving 3864 acute leukemia patients undergoing UCBT were included. Outcomes analyzed were acute graft-versus-host disease (GVHD), chronic GVHD, relapse, non-relapse mortality, leukemia-free survival and overall survival. Pooled risk ratios (RR) with 95% confidence intervals (CI) were calculated using a random effects model.
Results
The risk of Grade II-IV acute GVHD (RR 1.55, 95% CI 1.19–2.03) and Grade III-IV acute GVHD (RR 1.25, 95% CI 1.07–1.46) were significantly higher with dUCBT. Relapse risk was lower with dUCBT (RR 0.57, 95% CI 0.38–0.88) while overall survival favored sUCBT (RR 1.25, 95% CI 1.06–1.46). No significant differences were observed for chronic GVHD, non-relapse mortality or leukemia-free survival.
Conclusion
Both single and double UCBT have potential as effective treatments for acute leukemia. The choice of treatment should consider various factors, including the risk of GVHD, relapse, and mortality. More research, especially randomized trials, is needed to provide definitive guidance on the optimal use of single and double unit UCBT in patients with acute leukemia.
期刊介绍：
Leukemia Research an international journal which brings comprehensive and current information to all health care professionals involved in basic and applied clinical research in hematological malignancies. The editors encourage the submission of articles relevant to hematological malignancies. The Journal scope includes reporting studies of cellular and molecular biology, genetics, immunology, epidemiology, clinical evaluation, and therapy of these diseases.
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号
