Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis

Background: Matched donor (MD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently the preferred choice of treatment for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) patients who have achieved complete remission. This systematic review and meta-anal...

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Main Authors: Ben Ponvilawan, Weerapat Owattanapanich, Nipith Charoenngam, Smith Kungwankiattichai
Other Authors: Siriraj Hospital
Format: Article
Published: 2022
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Online Access:https://repository.li.mahidol.ac.th/handle/123456789/78572
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spelling th-mahidol.785722022-08-04T18:04:51Z Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis Ben Ponvilawan Weerapat Owattanapanich Nipith Charoenngam Smith Kungwankiattichai Siriraj Hospital Medicine Background: Matched donor (MD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently the preferred choice of treatment for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) patients who have achieved complete remission. This systematic review and meta-analysis was conducted to investigate the effects of allo-HSCTs from different donor types for Ph+ ALL patients who received tyrosine kinase inhibitors (TKIs). Methods: Studies in EMBASE and MEDLINE between inception and December 2020 were identified using search terms related to “Ph+ ALL” and “HSCT.” Eligible studies were studies with Ph+ ALL patients who received a TKI and allo-HSCT. The primary outcomes of interest—the overall survival (OS) or relapse-free survival (RFS)—needed to be reported. The Mantel–Haenszel method was used to combine the effect estimates and associated 95% confidence intervals (CIs) of each donor type. Results: Fourteen cohort studies were identified for the meta-analysis. Haploidentical (HID)-HSCT for Ph+ ALL patients resulted in a superior RFS to MD-HSCT, with a pooled odds ratio (OR) of 1.57 (95% CI, 1.05–2.32; I2 = 0%). However, HID-HSCT and MD-HSCT had comparable OS. Furthermore, HID-HSCT group had a significantly lower relapse rate than MD-HSCT group. On the other hand, the risks of graft-versus-host disease (GvHD) were higher for HID-HSCT and pooled OR of chronic GvHD rate. The OS and RFS of matched sibling-HSCT, matched unrelated-HSCT, and cord blood-HSCT were comparable with those of HID-HSCT. Conclusion: This systematic review and meta-analysis showed that HID-HSCT is as effective as MD-HSCT in Ph+ ALL patients. 2022-08-04T11:04:51Z 2022-08-04T11:04:51Z 2021-01-01 Article Hematology/ Oncology and Stem Cell Therapy. (2021) 10.1016/j.hemonc.2021.09.007 16583876 2-s2.0-85119170187 https://repository.li.mahidol.ac.th/handle/123456789/78572 Mahidol University SCOPUS https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85119170187&origin=inward
institution Mahidol University
building Mahidol University Library
continent Asia
country Thailand
Thailand
content_provider Mahidol University Library
collection Mahidol University Institutional Repository
topic Medicine
spellingShingle Medicine
Ben Ponvilawan
Weerapat Owattanapanich
Nipith Charoenngam
Smith Kungwankiattichai
Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis
description Background: Matched donor (MD) allogeneic hematopoietic stem cell transplantation (allo-HSCT) is currently the preferred choice of treatment for Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ ALL) patients who have achieved complete remission. This systematic review and meta-analysis was conducted to investigate the effects of allo-HSCTs from different donor types for Ph+ ALL patients who received tyrosine kinase inhibitors (TKIs). Methods: Studies in EMBASE and MEDLINE between inception and December 2020 were identified using search terms related to “Ph+ ALL” and “HSCT.” Eligible studies were studies with Ph+ ALL patients who received a TKI and allo-HSCT. The primary outcomes of interest—the overall survival (OS) or relapse-free survival (RFS)—needed to be reported. The Mantel–Haenszel method was used to combine the effect estimates and associated 95% confidence intervals (CIs) of each donor type. Results: Fourteen cohort studies were identified for the meta-analysis. Haploidentical (HID)-HSCT for Ph+ ALL patients resulted in a superior RFS to MD-HSCT, with a pooled odds ratio (OR) of 1.57 (95% CI, 1.05–2.32; I2 = 0%). However, HID-HSCT and MD-HSCT had comparable OS. Furthermore, HID-HSCT group had a significantly lower relapse rate than MD-HSCT group. On the other hand, the risks of graft-versus-host disease (GvHD) were higher for HID-HSCT and pooled OR of chronic GvHD rate. The OS and RFS of matched sibling-HSCT, matched unrelated-HSCT, and cord blood-HSCT were comparable with those of HID-HSCT. Conclusion: This systematic review and meta-analysis showed that HID-HSCT is as effective as MD-HSCT in Ph+ ALL patients.
author2 Siriraj Hospital
author_facet Siriraj Hospital
Ben Ponvilawan
Weerapat Owattanapanich
Nipith Charoenngam
Smith Kungwankiattichai
format Article
author Ben Ponvilawan
Weerapat Owattanapanich
Nipith Charoenngam
Smith Kungwankiattichai
author_sort Ben Ponvilawan
title Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis
title_short Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis
title_full Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis
title_fullStr Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis
title_full_unstemmed Effects of different types of allogeneic hematopoietic stem cell transplantation donors on Philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: A systematic review and meta-analysis
title_sort effects of different types of allogeneic hematopoietic stem cell transplantation donors on philadelphia chromosome-positive acute lymphoblastic leukemia during the tyrosine kinase inhibitor era: a systematic review and meta-analysis
publishDate 2022
url https://repository.li.mahidol.ac.th/handle/123456789/78572
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