Allo-HSCT compared with immunosuppressive therapy for acquired aplastic anemia: a system review and meta-analysis

BMC Immunology
Yangmin ZhuFengkui Zhang

Abstract

Allogeneic hematopoietic stem cell transplantation (allo-HSCT) and immunosuppressive therapy (IST) are two major competing treatment strategies for acquired aplastic anemia (AA). Whether allo-HSCT is superior to IST as a front-line treatment for patients with AA has been a subject of debate. To compare the efficacy and safety of allo-HSCT with that of IST as a front-line treatment for patients with AA, we performed a meta-analysis of available studies that examined the impact of the two major competing treatment strategies for AA. Fifteen studies including a total of 5336 patients were included in the meta-analysis. The pooled hazard ratio (HR) for overall survival (OS) was 0.4 (95% CI 0.074-0.733, P = 0.016, I2 = 58.8%) and the pooled HR for failure-free survival (FFS) was 1.962 (95% CI 1.43-2.493, P = 0.000, I2 = 0%). The pooled relative risk (RR) for overall response rate (ORR) was 1.691 (95% CI 1.433-1.996, P = 0.000, I2 = 11.6%). Although survival was significantly longer among AA patients undergoing first-line allo-HSCT compared to those undergoing first-line IST, the selection of initial treatment for patients with newly diagnosed AA still requires comprehensive evaluation of donor availability, patient age, expected qua...Continue Reading

References

May 8, 1997·The New England Journal of Medicine·N S Young, J Maciejewski
Jan 10, 2001·Bone Marrow Transplantation·M FouladiM H Freedman
Apr 3, 2002·Annals of Internal Medicine·Neal S Young
Dec 22, 2005·American Journal of Hematology·David W KaufmanNeal S Young
Jul 2, 2015·The New England Journal of Medicine·Tetsuichi YoshizatoSeishi Ogawa
Nov 17, 2015·British Journal of Haematology·Sally B KillickUNKNOWN British Society for Standards in Haematology
Dec 26, 2016·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Amy E DeZernRobert A Brodsky
Mar 8, 2017·Expert Review of Hematology·Seiji Kojima
Apr 20, 2017·The New England Journal of Medicine·Danielle M TownsleyNeal S Young
Aug 16, 2018·Blood Advances·George E GeorgesRainer Storb
Jan 19, 2019·Biology of Blood and Marrow Transplantation : Journal of the American Society for Blood and Marrow Transplantation·Shiwei YangZunmin Zhu

❮ Previous
Next ❯

Methods Mentioned

BETA
MDS

Software Mentioned

TWiST
Stata

Related Concepts

Related Feeds

Blood And Marrow Transplantation

The use of hematopoietic stem cell transplantation or blood and marrow transplantation (bmt) is on the increase worldwide. BMT is used to replace damaged or destroyed bone marrow with healthy bone marrow stem cells. Here is the latest research on bone and marrow transplantation.

Allogenic & Autologous Therapies

Allogenic therapies are generated in large batches from unrelated donor tissues such as bone marrow. In contrast, autologous therapies are manufactures as a single lot from the patient being treated. Here is the latest research on allogenic and autologous therapies.