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肝突阻塞综合征/静脉封闭性疾病 (SOS/VOD) 血液造血干细胞移植患者的初级预防:随机对照试验的网络元分析

Mário Sousa-Pimenta^1,2,3, Ângelo Martins¹, Letícia M Estevinho^4,5

¹Department of Hematology and Bone Marrow Transplantation, Portuguese Oncology Institute of Porto (IPO-Porto), 4200-072 Porto, Portugal.

Journal of clinical medicine

|November 27, 2024

概括

在血造干细胞移植 (HSCT) 后,乌尔索多胆酸 (UDCA) 在预防肝脏侧阻塞综合征/静脉闭塞性疾病 (SOS/VOD) 方面表现有前途. 这一元分析表明,UDCA对所有接受HSCT的患者可能比defibrotide更有效.

科学领域:

血液学血液学血液学
移植医学移植医学
药理学药理学是指药理学的学科.

背景情况:

肝突阻塞综合征/静脉封闭性疾病 (SOS/VOD) 是血液造血干细胞移植 (HSCT) 的严重并发症.
早期识别和预防策略对于管理高风险的SOS/VOD患者至关重要.
现有的预防性治疗需要系统评估,以确定最佳的临床应用.

研究的目的:

系统地审查和比较不同初级预防策略对SOS/VOD在HSCT患者的疗效.
在HSCT中为SOS/VOD预防提供基于证据的建议.

主要方法:

随机临床试验的系统审查和元分析.
使用网络元分析来比较多种预防策略.
几率比率 (OR) 和累积排名曲线下的面积 (SUCRA) 被计算出来,以评估有效性和排名.

主要成果:

在所有HSCT患者中,乌尔索多胆酸 (UDCA) 与VOD的发病率降低有关 (OR = 0.38,SUCRA = 0.720).
在所有患者中,Defibrotide显示VOD发病率的适度降低 (OR = 0.64,SUCRA = 0.486).
在一小组异构HSCT接受者中,UDCA (OR = 0.53,SUCRA = 0.639) 和defibrotide (OR = 0.51,SUCRA = 0.650) 均表现出相似的疗效,两者都没有明显优于对方.

结论:

这一元分析是第一个直接比较SOS/VOD.的主要预防剂的元分析.
在一般的HSCT人群中,UDCA似乎是SOS/VOD预防的有前途的药物.
对于全基性HSCT,UDCA和defibrotide显示了可比的预防作用.

关键词:

这就是Defibrotide.新鲜冷的血.造血干细胞移植造血干细胞移植肝素是一种肝素.预防预防预防预防阴侧阻塞综合征/静脉闭塞性疾病 (SOS/VOD)乌尔索多氧胆酸是什么意思

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