Comparison Of The Efficacy Between Auto-HSCT And Allo-HSCT Combined With TKIs For Patients With Ph+ALL:A Meta Analysis

Objective: To investigate the efficacy between autologous transplantation and allogeneic transplantation combined with TKIs for adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia(Ph+ ALL).Method: The databases of PubMed,EMBASE,Cochrane Library,CNKI,Wanfang Data and VIP were retrieved by computer.Effects of TKIs combined with autologous transplantation or allogeneic transplantation in the treatment of adult Philadelphia chromosome-positive acute lymphoblastic leukemia were evaluated.The retrieval time was from the database establishment to January 31,2020.Two researchers independently screened the related literature according to the inclusion and exclusion standards,extracted the data and evaluated the methodologic quality of included studies.The RevMan5.3 software was used for conducting the Meta analysis.Results: There are 892 related literatures were searched.Finally,there were 5 literatures included 872 patients,of which 136 were autologousgroup and 736 were allogeneic group.Meta analysis showed that there were no significant differences in overall survival rate [RR=1.05,95%CI(0.91,1.20),P=0.50],disease-free survival rate [RR=1.16,95%CI(0.77,1.74),P=0.48] or nonrelapsed mortality rate [RR=0.42,95%CI(0.00,60.76),P=0.73].However,the relapse rate of autologous group was higher [RR=2.00,95%CI(1.52,2.63),P<0.00001],and the difference was statistically significant.Conclusions: TKIs combined with autologous transplantation can benefit the patients of Ph+ ALL who cannot tolerate allogeneic hematopoietic stem cell transplantation.