两种不同移植预处理方案对儿童血液病并发症和生存率影响的Meta分析

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。

Impact of Total Body Irradiation (TBI) with Cyclophos-phamide (TBI/CY) versus Bulsulphan with Cyclophos-phamide (BU/CY) as Condition Regimens on Complication and Survival in Hematological Stem Cell Transplantation for Children with Hematologic Disease: A Meta-analysis

Purpose] To compare the therapeutic efficacy and toxicity of total body irradiation with cyclophosphamide (TBI/CY) versus bulsulphan with cyclophosphamide (BU/CY) as condition regi-mens in hematological stem cell transplantation for children with hematologic disease. Methods] Articles on comparative studies with different condition regimens in hematological stem cell trans-plantation for children published from 1990 to 2007 were searched from the Cochrane Central Reg-ister of Controlled Trials, MEDLINE, C...