羅特西普治療骨髓增生異常綜合征患者貧血的有效性與安全性的單組率Meta分析
中圖分類號R979.1 文獻(xiàn)標(biāo)志碼A 文章編號 1001-0408(2025)09-1135-06
DOI10.6039/j.issn.1001-0408.2025.09.20
ABSTRACTOBJECTIVETo analyze theeficacyand safetyof luspatercept in the treatment of myelodysplastic syndromes (MDS)anemia,andprovidereferenceforclinicalmedication.METHODSTheliteraturerelatedtoluspaterceptforMDSanemiain PubMed,CochraneLibrary,EmbaseandWebof Science weresearchedbycomputer,and thesearch timewas from the establishmentofthedatabasetoJanuary 2024.Thequalityof literaturewasevaluatedaftertheywerescrenedaccordingto inclusionand exclusioncriteria,thesingle-grouprate meta-analysisandsensitivityanalysis were performedbyusing RevMan5.4 software,andthesubgroupanalysis wasconducted.RESULTSAtotalof756patientsin9articleswereincludedinthisstudyTe results of meta-analysis showed that the proportion of MDS patients who reached ? 8 weeks of red blood cell transfusion independence(RBC-TI)was 4 6 % after using luspatercept [ 9 5 % C ] (0.28,0.64), P<0 . 0 0 0 01]. The proportion of MDS patients whose hematological improvement in erythrocyte(HI-E)was 5 9 % 二 [ 9 5 % C ] (0.43,0.74), P<0 . 0 0 0 01].Among them,5articles reported that the proportion of MDS patients with grade 3-4 adverse reactions was 1 4 % [ 9 5 % C ] (0.07,0.22), P=0 . 0 0 0 2],and thepoorgeneralcondition,infection,bloodandlymphaticsystemdiseasewerethecommonadversereactions.Subgroupanalysis
showed that the source of heterogeneity was the blood transfusion burden in the proportion of MDS patients with RBC-TI ? 8 weeks,and the source of heterogeneity was the revised international prognostic scoring system (IPSS-R)risk grade,SF3B1 mutation status and blood transfusion burden in
theproportionofMDSpatients with HI-E.Sensitivityanalysis showedthattheresultsofthisstudywere stable.CONCLUSIONS Luspaterceptcansignificantlyimprovebloodtransfusion dependence,reducebloodtransfusion burdenand promotehematology improvement inMDSpatients.Butatentionshouldbepaidtotheoccurrenceof grade3-4adverseevents;adverseeventssuchas poor general condition,infection,blood and lymphatic system diseases are more common.
KEYWORDsluspatercept;myelodysplastic syndromes;anemia;efficacy;safety
骨髓增生異常綜合征(myelodysplasticsyndrome,MDS)是一種起源于造血十細(xì)胞的異質(zhì)性髓系腫瘤,其特征包括骨髓發(fā)育不良、復(fù)發(fā)性遺傳異常、造血系統(tǒng)發(fā)育不良、外周血細(xì)胞減少,以及進(jìn)展為急性髓細(xì)胞性白血?。╝cutemyelogenousleukemia,AML)的高風(fēng)險(xiǎn)[1]。(剩余11201字)
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