粒细胞集落刺激因子治疗急性淋巴细胞白血病疗效和安全性的系统评价  

Effectiveness and Safety of G-CSF for Acute Lymphoblastic Leukemia:A Systematic Review

作　　者：李培[1] 席亚明[1] 徐建旺[1] 张豪[1] 李明[1] 邓伟[1] 

机构地区：[1]兰州大学第一医院血液科,血液学研究所,兰州730000

出　　处：《中国循证医学杂志》2010年第8期985-990,共6页Chinese Journal of Evidence-based Medicine

摘　　要：目的系统评价粒细胞集落刺激因子(G-CSF)对急性淋巴细胞白血病(ALL)患者的疗效和安全性。方法计算机检索Cochrane Library、PubMed、EMbase、中国期刊全文数据库和维普中文科技期刊数据库,检索时间2000年1月～2009年10月。纳入G-CSF治疗急性淋巴细胞白血病的随机对照研究。按Cochrane系统评价方法评价纳入研究的方法学质量和提取有效数据,用RevMan 5.0软件对总体生存率、诱导化疗结束后的完全缓解率、生存质量、感染情况、复发率、不良反应等进行Meta分析。结果共纳入6个随机对照试验,共620例患者,研究质量均为C级。Meta分析结果显示G-CSF组在成人ALL总体生存率[RR=2.24,95%CI(1.28,3.90),P=0.004]方面优于对照组。结论 G-CSF可提高成人ALL患者的总体生存率,尚不能证明其有提高完全缓解率、改善生存质量、减少感染情况、降低复发率的作用,有待进一步研究证实。Objective To assess the clinical effectiveness and safety of granulocyte colony stimulating factor（G-CSF）for patients with acute lymphoblastic leukemia（ALL）.Methods We searched the Cochrane Library,PubMed,EMbase,CNKI,and VIP databases from January 2000 to October 2009.Randomized controlled trials（RCTs）about G-CSF for patients with ALL were retrieved.The methodological quality of the included studies was assessed and the data was extracted according the Cochrane Reviewer＇s Handbook.Meta-analyses for overall survival,complete remission,quality of life,infections,relapse rate,and adverse events were performed using RevMan 5.0 software.Results Six RCTs involving 620 patients with ALL were included.The results of meta-analyses showed that the G-CFS group was superior to the control group in the overall survival of adult ALL patients（RR=2.24,95%CI 1.28 to 3.90,P=0.004）.Conclusion G-CSF can improve the overall survival of adult ALL patients.However,it is not demonstrated that G-CSF could improve complete remission rate and quality of life,and reduce infections and relapse rate.More high-quality and large scale RCTs are required.

关 键 词：粒细胞集落刺激因子 急性淋巴细胞白血病 META分析 系统评价 

分 类 号：R733.71[医药卫生—肿瘤]