含高三尖杉酯碱方案治疗急性髓系白血病疗效与安全性评价

Efficacy and Safety of Homoharringtonine-Contained Regimen in Patients with Acute Myeloid Leukemia

[目的]用meta分析系统评价含高三尖杉酯碱（homoharringtonine，HHT）方案治疗急性髓系白血病（acute myeloid leukemia，AML）的疗效、并发症及不良反应。[方法]计算机检索PubMed、The Cochrane Library、EMbase、VIP、WanFang Data、CBM和CNKI数据库，检索时限均为从建库至2015年1月，收集HHT治疗AML的临床试验。由两位研究者按照纳入与排除标准，独立进行文献筛选、资料提取和评价纳入研究的方法学质量，采用RevMan5．2软件进行Meta分析。[结果]共纳入7项研究，1051例患者；Meta分析结果显示：含HHT组的方案的完全缓解率（complete remission，CR）及3年无病生存率（event free survival，EFS）高于柔红霉素＋阿糖胞苷（DA）组（P〈0．05），但白细胞减少、出血和感染发生率等并发症与DA组比较差异无统计学意义（P〉0．05）；心脏损害和心脏损害等不良反应发生率明显低于DA组。[结论]含HHT的方案治疗AML安全而有效，且不增加并发症的发生率；HHT获取方便，价格低廉，对于AML的治疗是一种较好的选择，值得临床推广应用。

[Objective]To evaluate the efficacy, complications and adverse reactions of HHT （homoharringtonine）-contained regimen in patients with acute myeloid leukemia （AML） by meta analysis.[Methods] A collection of clinical trials for the treatment of AML HHT was performed through searching the PubMed, the Cochrane Library, EMbase, VIP, WanFang Data, CBM and CNKI databases from inception to January 2015. According to the inclusion and exclusion criteria, two researchers were selected to carry out the research of literature selection, data extraction and evaluation. The Meta analysis was conducted by using RevMan 5.2 software.[Results] Seven trials involving in a total of 1,051 patients were included. The results of meta-analysis showed that： the HHT group was superior to the DA group in terms of CR（complete remission） rate and 3-years EFS（event free survival）rate（ P 〈0.05）, but the difference of complications such as white blood cell reduction, bleeding, and infection rates was not statistically significant compared with the DA group （ P 〉0.05）; The incidence of adverse reactions such as cardiac injury was significantly lower than that of the DA group. [Conclusion] HHT containing regimen is safe and effective for the treatment of AML, and does not increase the incidence of complications. With easy access and low prices, HHT is a good choice for the treatment of AML and is worthy of clinical application.