ABO血型不合对外周血造血干细胞移植GVHD影响的Meta分析

目的:移植物抗宿主病(GVHD)是异基因造血干细胞移植(allo-HSCT)中常见的并发症,其与ABO血型不合的关系尚存在争议,本研究利用Meta分析评价ABO血型不合对外周血造血干细胞移植GVHD的影响。方法:使用关键词检索PubMed,筛选出与本研究目的相符的文献,采用Review Manager 5.0统计软件进行分析。结果:初筛65篇文献,最终纳入6篇文献共计884例,其中血型不合417例,血型相合467例。血型不合组(包括主侧不合、次侧不合和主次侧均不合)发生aGVHD的OR=1.53(P=0.004),仅计算次侧不合组OR=1.40(P=0.14),cGVHD在血型相合与不合组之间无统计学差异。结论:Meta分析支持ABO血型不合提高外周血造血干细胞移植aGVHD的风险,但对cGVHD无影响。清髓方案可能促进ABO血型不合移植受者发生aGVHD。

Meta-analysis of ABO incompatibility on GVHD in peripheral blood stem cell transplantation

Objective：Graft-versus-host disease （GVHD） is a common complication in allo-hemotopoietic stem cell transplantation （HSCT）, whether ABO incompatibility promotes GVHD during HSCT is still controversial. We make use of Meta-analysis to evaluate the risk of GVHD in ABO incompatible HSCT. Method：We searched literatures on PubMed with key words, which were checked by reviewers and included cases were analyzed by Review Manager 5.0. Result：We selected 6 out of 65 literatures totaling 884 cases with 417 incompatible and 467 compatible cases. OR of aGVHD in ABO incompatible group was 1.53 （P=O. 004） and 1.40 for minor incompatible group, however no statistical significance for cGVHD. Conclusion： Our recta-analysis support the idea that ABO incompatibility increased the risk of aGVHD in peripheral blood stem cell transplantation, with little effect on cGVHD. Myeloablative HSCT may accelerate the effect of ABO incompatibility on aGVHD.