摘要
[目的]观察全身照射加环磷酰胺（TBI／CY）与马利兰加环磷酰胺（BU／CY）两种不同的移植预处理方案对儿童造血干细胞移植的治疗效果和毒副反应。[方法]计算机检索Cochrane、MEDLINE、CNKI、CBM在1990～2007年期间发表的关于儿童移植中对比不同预处理方案的研究文献。从干细胞植入、移植后的并发症、长期生存率等方面进行对比分析。采用Review Manager软件进行Meta分析。[结果]检索出4012篇文献，最终纳入10个试验共2475例患者。TBI／CY与BU／CY组相比植入失败率无明显区别（P=0．23）：TBI／CY组治疗相关死亡率明显低于BU／CY组（OR=O．53，95％CI：0．40—0．71，P〈0．0001），而长期无病生存率TBI／CY组则明显优于BU／CY组（OR=1．46，95％CI：1．19～1.80，P=0．0003）。[结论]Meta分析表明TBI／CY预处理方案是儿童血液病移植的有效方案．而TBI对儿童生长发育的长期不良影响有待进一步探讨。
[Purpose ] To compare the therapeutic efficacy and toxicity of total body irradiation with cyclophosphamide （TBI/CY） versus bulsulphan with cyclophosphamide （BU/CY） as condition regimens in hematological stem cell transplantation for children with hematologic disease. [Methods ] Articles on comparative studies with different condition regimens in hematological stem cell transplantation for children published from 1990 to 2007 were searched from the Cochrane Central Register of Controlled Trials, MEDLINE, CNKI, and Chinese Bio-medicine Database （CBM）. Stem cell engraftment, complication after transplantation and long-term survival were compared. A meta-analysis by Review Manager 4.2 software was carried out. [Results] Four thousand and twelve articles were searched out. Ten trials with 2475 patients were enrolled in the Meta-analysis. The incidence of engraftment failure was not significantly different between TBI/CY group and BU/CY group （P= 0.23）. Transplantation-related mortality（TRM） in TBI/CY group was significantly lower than that in BU/CY group （OR=0.53,95%CI：0.40-0.71,P〈0.0001）. TBI/CY group had a favorite long diseasefree survival rate over BU/CY group（OR=1.46,95%CI：1.19-1.80,P=0.0003）. [Conclusions] Metaanalysis shows that TBI/CY condition regimen is effective for children with hematologic disease, but the long term toxicity needs to be further investigated.
出处
《中国肿瘤》
CAS
2008年第11期989-993,共5页
China Cancer
关键词
预处理
移植
META分析
儿童
血液病
condition regimen
transplantion
Meta-analysis
children
hematological diseases
