摘要
In the present study, we aimed to assess the efficacy and safety of Homoharringtonine （HHT） for chronic myelogenous leukemia （CML）. Databases, such as PubMed, the Cochrane Library, EMbase, CENTRAL, VIP, WanFang Data, CBM and CNKI, were electronically searched from inception to May 2014 for clinical trials on HHT for CML. Literatures were independently screened by two reviewers based on the inclusion and exclusion criteria, data were extracted, and methodological quality was assessed accordingly. Meta-analysis was performed using RevMan 5.2. Five trials were included consisting of a total of 423 patients. The results of meta-analysis showed that the HHT group was superior to the hydroxycarbamide （HU） group in terms of complete hematologic response rate （CHR）, major cytogenetic responses （MCyR） rate, partial cytogenetic responses （PCyR） rate, blast rate and 4-year survival rate. There was no statistical difference in complete cytogenetic response （CCyR） and minor cytogenetic response （mCyR） rates between the HHT group and HU group. HHT caused less adverse reaction. Therefore, HHT alone showed considerable short-term and long-term efficacy in the treatment of late-phase CML. It could be a good choice for some CML. Since moderate selection bias might exist in the methodological quality of the included studies which might affect the authenticity of outcomes, our conclusions should be further proved by conducting more high-quality, large-scale and double-blinded randomized controlled trials （RCTs）.
本文旨在系统评价高三尖杉酯碱巩固治疗慢性粒细胞白血病的疗效和安全性。通过计算机检索PubMed、The Cochrane Library、EMbase、VIP、WanFang Data、CBM和CNKI数据库,检索时限均为从建库至2014年5月,收集高三尖杉酯碱治疗慢性粒细胞白血病的随机对照试验。由两位研究者按照纳入与排除标准,独立进行文献筛选、资料提取和评价纳入研究的方法学质量。采用RevMan 5.2软件进行Meta分析。结果共纳入5项研究,423例患者。Meta分析结果显示:高三尖杉酯碱组的完全血液学反应率、主要细胞遗传学反应率和部分细胞遗传学反应率高于羟基脲组,完全细胞遗传学反应率和轻微细胞遗传学反应率均高于羟基脲组。高三尖杉酯碱组急变率低于羟基脲组,4年预期生存率高于羟基脲组。高三尖杉酯碱的药物不良反应较轻。结果提示,单用高三尖杉酯碱巩固治疗慢性粒细胞白血病具有较好的短期和远期疗效,可作为部分患者的一个治疗选择。鉴于纳入研究的方法学质量存在中度选择性偏倚的可能性,有待开展更多高质量大样本的随机双盲临床对照试验来验证。
