化疗后自体造血干细胞移植治疗恶性淋巴瘤的有效性和可靠性:荟萃分析。

IF 2.9 4区 医学 Q3 ENDOCRINOLOGY & METABOLISM Discover. Oncology Pub Date : 2025-02-13 DOI:10.1007/s12672-025-01876-x
Hend Ahmed, Ahmed S Shafiey, Mohamed E A Abdelrahim
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摘要

背景:自体造血干细胞移植(AHSCT)是几种血液系统恶性肿瘤的有价值的治疗选择,特别是在复发或难治性病例中。自体造血干细胞移植(AHSCT)可有效提高特定患者的生存率,尤其是侵袭性淋巴瘤和多发性骨髓瘤患者。研究表明AHSCT可能优于其他治疗方法,但正在进行的研究对于改进患者选择至关重要。许多患者的缓解期延长,生活质量改善,这表明需要长期随访来评估晚期效应和总生存期。本研究旨在建立荟萃分析,系统评价自体干细胞治疗(AHSCT)在高剂量化疗后恶性淋巴瘤治疗中的安全性和有效性,并得出可靠的结果,为临床应用和参考提供基础。方法:系统检索2017年2月至2024年8月的文献,将恶性淋巴瘤确定为研究对象的诊断。实验组在大剂量化疗后确定为AHSCT,对照组则进行标准化疗(不限制化疗方案)。结果指标为无进展生存期(PFS)、完全缓解率(完全缓解(CR) +部分缓解(PR))和总生存期(OS)。结果:共纳入文献15篇,对照组1229人,实验组896人。对照组采用常规化疗(不限制化疗方案)作为干预策略。优势比(OR)为2.23,95%可信区间(CI)为[1.54,3.22],Z = 4.25;结论:接受化疗的恶性淋巴瘤患者通过AHSCT治疗可显著延长其总生存期和无进展生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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The effectiveness and reliability of autologous hematopoietic stem cell transplantation following chemotherapy in managing malignant lymphoma: a meta-analysis.

Background: Autologous hematopoietic stem cell transplantation (AHSCT) is a valuable treatment option for several hematological malignancies, particularly in relapsed or refractory cases. Autologous hematopoietic stem cell transplantation (AHSCT) is effective in improving survival rates in selected patients, particularly those with aggressive lymphomas and multiple myeloma. Studies suggest AHSCT may outperform alternative therapies, but ongoing research is essential to refine patient selection. Many patients enjoy prolonged remission and improved quality of life, indicating the need for long-term follow-up to assess late effects and overall survival. This work aimed to establish meta-analysis to methodically evaluate the safety and effectiveness of autologous stem cell therapy (AHSCT) in the management of malignant lymphoma following high-dose chemotherapy and to produce reliable findings that may serve as a foundation for clinical application and reference.

Methods: A systematic literature search was performed from February 2017 to August 2024, and malignant lymphoma was identified as the study subjects' diagnosis. The experimental group was identified as AHSCT afterwards high-dose chemotherapy, while the control group underwent standard chemotherapy (with no restrictions on the chemotherapy regimen). The outcome indicators were progression-free survival (PFS), complete remission rate (complete response (CR) + partial response (PR)), and overall survival (OS).

Results: Fifteen literature pieces in all, consisting of 1229 subjects in the control group and 896 subjects in the experimental group, were included. Conventional chemotherapy (chemotherapy regimen not limited) was the intervention strategy used in the control group. The odds ratio (OR) was 2.23, with a 95% confidence interval (CI) of [1.54, 3.22], Z = 4.25; P < 0.0001, indicating that the groups differed in overall survival and progression-free survival rates. Similarly, the progression-free survival rate was 2.70, with a 95% CI of 1.86-3.92, Z = 4.25; P < 0.0001, and overall survival was 2.23.

Conclusions: Patients with malignant lymphoma who receive chemotherapy can substantially extend their overall survival and progression-free survival rates with AHSCT treatment.

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来源期刊
Discover. Oncology
Discover. Oncology Medicine-Endocrinology, Diabetes and Metabolism
CiteScore
2.40
自引率
9.10%
发文量
122
审稿时长
5 weeks
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