{"title":"造血干细胞移植在儿童和成人患者中的比较分析:系统回顾和荟萃分析。","authors":"Shailendra Shanker Maurya, Nitin Sagar, Sumit Chaturvedi, Maneesha Pandey, Sapana Kushwaha, Rajesh Kashyap","doi":"10.3389/frtra.2025.1551820","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong>Hematopoietic stem cell transplantation (HSCT) is a significant treatment option for acute myeloid leukemia (AML). However, some important questions remain related to its efficacy and safety, specifically when administered to various age cohorts among pediatric and adult patients.</p><p><strong>Aim: </strong>This study aimed to investigate the efficacy of HSCT in treating pediatric patients compared to adult patients diagnosed with AML.</p><p><strong>Methods: </strong>A systematic search was conducted in PubMed, Scopus, Google Scholar, and Medline for studies published in the English language from inception to 2023. The findings were reported using the PRISMA checklist. Statistical analysis was conducted using Cochrane's software (Rev Man) version 5.4, which used random and fixed effect models when necessary.</p><p><strong>Results: </strong>In total, 14 studies met the criteria for meta-analysis. The results indicated a slightly positive trend in overall survival in the pediatric and combined pediatric-adult groups compared to adults alone, although the differences were not statistically significant. For relapse rate, no significant differences were observed in the adult and pediatric groups individually, while the combined pediatric-adult group showed a substantial benefit from HSCT (OR: 2.3, <i>P</i>-value: -0.05). A similar trend was observed in disease-free survival, where the combined group showed a modest, though not statistically significant, improvement with HSCT. Furthermore, regarding treatment-related mortality, a statistically protective effect of HSCT was observed in the adult group (OR: 0.26, <i>P</i> = 0.0005), while the pediatric and combined groups did not show significant effects. For graft-vs.-host disease, a significant association with HSCT was found in the pediatric group (OR: 2.58, <i>P</i> = 0.03), while the adult and combined groups showed no significant effects.</p><p><strong>Conclusion: </strong>Our analysis showed mixed results, showing a slightly better effect of HSCT in treating pediatric patients diagnosed with AML compared to adult patients.</p>","PeriodicalId":519976,"journal":{"name":"Frontiers in transplantation","volume":"4 ","pages":"1551820"},"PeriodicalIF":0.0000,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12176822/pdf/","citationCount":"0","resultStr":"{\"title\":\"A comparative analysis of hematopoietic stem cell transplantation in pediatric and adult patients: a systematic review and meta-analysis.\",\"authors\":\"Shailendra Shanker Maurya, Nitin Sagar, Sumit Chaturvedi, Maneesha Pandey, Sapana Kushwaha, Rajesh Kashyap\",\"doi\":\"10.3389/frtra.2025.1551820\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Introduction: </strong>Hematopoietic stem cell transplantation (HSCT) is a significant treatment option for acute myeloid leukemia (AML). 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The results indicated a slightly positive trend in overall survival in the pediatric and combined pediatric-adult groups compared to adults alone, although the differences were not statistically significant. For relapse rate, no significant differences were observed in the adult and pediatric groups individually, while the combined pediatric-adult group showed a substantial benefit from HSCT (OR: 2.3, <i>P</i>-value: -0.05). A similar trend was observed in disease-free survival, where the combined group showed a modest, though not statistically significant, improvement with HSCT. Furthermore, regarding treatment-related mortality, a statistically protective effect of HSCT was observed in the adult group (OR: 0.26, <i>P</i> = 0.0005), while the pediatric and combined groups did not show significant effects. 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引用次数: 0
摘要
简介:造血干细胞移植(HSCT)是急性髓性白血病(AML)的重要治疗选择。然而,一些重要的问题仍然与它的有效性和安全性有关,特别是在儿科和成人患者的不同年龄组中。目的:本研究旨在探讨HSCT治疗儿科患者与诊断为AML的成人患者的疗效。方法:系统检索PubMed、Scopus、谷歌Scholar和Medline,检索从成立到2023年以英语发表的研究。使用PRISMA检查表报告结果。统计分析采用Cochrane软件(Rev Man) 5.4版,必要时采用随机效应模型和固定效应模型。结果:总共有14项研究符合meta分析的标准。结果表明,与单独的成人相比,儿科和儿科-成人联合组的总生存率略有上升,尽管差异没有统计学意义。复发率方面,成人组和儿童组之间没有显著差异,而儿童-成人联合组从HSCT中获益显著(OR: 2.3, p值:-0.05)。在无病生存中也观察到类似的趋势,联合组在HSCT中表现出适度的改善,尽管没有统计学上的显著性。此外,在治疗相关死亡率方面,HSCT在成人组中有统计学保护作用(OR: 0.26, P = 0.0005),而儿科组和联合组没有显着作用。graft-vs。儿童组与HSCT有显著相关性(OR: 2.58, P = 0.03),而成人组和联合组无显著影响。结论:我们的分析结果喜忧参半,与成人患者相比,HSCT治疗诊断为AML的儿科患者的效果略好。
A comparative analysis of hematopoietic stem cell transplantation in pediatric and adult patients: a systematic review and meta-analysis.
Introduction: Hematopoietic stem cell transplantation (HSCT) is a significant treatment option for acute myeloid leukemia (AML). However, some important questions remain related to its efficacy and safety, specifically when administered to various age cohorts among pediatric and adult patients.
Aim: This study aimed to investigate the efficacy of HSCT in treating pediatric patients compared to adult patients diagnosed with AML.
Methods: A systematic search was conducted in PubMed, Scopus, Google Scholar, and Medline for studies published in the English language from inception to 2023. The findings were reported using the PRISMA checklist. Statistical analysis was conducted using Cochrane's software (Rev Man) version 5.4, which used random and fixed effect models when necessary.
Results: In total, 14 studies met the criteria for meta-analysis. The results indicated a slightly positive trend in overall survival in the pediatric and combined pediatric-adult groups compared to adults alone, although the differences were not statistically significant. For relapse rate, no significant differences were observed in the adult and pediatric groups individually, while the combined pediatric-adult group showed a substantial benefit from HSCT (OR: 2.3, P-value: -0.05). A similar trend was observed in disease-free survival, where the combined group showed a modest, though not statistically significant, improvement with HSCT. Furthermore, regarding treatment-related mortality, a statistically protective effect of HSCT was observed in the adult group (OR: 0.26, P = 0.0005), while the pediatric and combined groups did not show significant effects. For graft-vs.-host disease, a significant association with HSCT was found in the pediatric group (OR: 2.58, P = 0.03), while the adult and combined groups showed no significant effects.
Conclusion: Our analysis showed mixed results, showing a slightly better effect of HSCT in treating pediatric patients diagnosed with AML compared to adult patients.