治疗急性淋巴细胞白血病的患者的静脉血栓栓塞预防:全面的系统审查和元分析
Bareq S Al Lami1, Shad B Aziz2, Yousif N Al-Tawil2
1General Medicine, Hawler Medical University, Erbil, IRQ.
Cureus
|October 25, 2024
概括
血栓预防显著降低了急性淋巴细胞白血病 (ALL) 的儿童静脉血栓栓塞 (VTE) 的风险. 这种使用阿皮克萨班,埃诺沙巴林或抗血的策略没有增加出血并发症.
科学领域:
- 血液学 血液学 血液学
- 在瘤学瘤学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 急性淋巴细胞白血病 (ALL) 是一种常见的儿童癌症,需要密集化疗.
- 静脉血栓塞栓症 (VTE) 是ALL治疗期间的一种严重并发症,影响患者的治疗结果.
- 血栓预防在预防ALL患者的VTE的作用需要进一步澄清.
研究的目的:
- 系统地审查和元分析血栓预防治疗在ALL治疗期间减少静脉瘤发病率的有效性和安全性.
- 为了评估特定的药物,包括抗血素,阿皮克萨班和埃诺沙巴林.
主要方法:
- 按照PRISMA指南进行系统的文献搜索.
- 包括ALL中血栓预防的随机对照试验 (RCT).
- 使用Review Manager软件进行元分析,评估VTE和出血风险.
主要成果:
- 三项RCT满足了纳入标准,评估了阿皮克萨班,埃诺沙巴林和抗血素.
- 血栓预防显著降低了静脉突发症的几率 (OR:0.47,95% CI 0.29-0.75) 和相对风险 (RR:0.52,95% CI 0.33-0.83).
- 没有观察到出血风险显著增加 (OR: 1.33,95% CI 0.42-4.21;RR: 1.32,95% CI 0.43-4.07).
结论:
- 使用阿皮克萨班,埃诺沙巴林或抗血栓的血栓预防有效降低ALL患者的静脉动脉突发症发病率.
- 这些发现支持实施定制的血栓预防策略.
- 需要进一步的研究来优化这些策略,并解决异质性和潜在的偏见.
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