Objective To evaluate the effectiveness and safety of chemotherapy regimens represented by pirarubicin (THP) vs. adriamycin hydrochloride (ADM) for non-Hodgkin lymphoma (NHL) in mainland China. Methods The randomized controlled trials (RCTs) about THP vs. ADM for treating NHL were collected in the databases such as CNKI, CBM, VIP and WanFang Data, and the references of the included studies were also retrieved manually, with the retrieval time from January 1989 to September 2012. According to the inclusion and exclusion criteria, two reviewers independently screened articles, extracted data, and assessed the methodological quality of the included studies. Then meta-analysis was performed using RevMan 5.0 software. Results A total of 15 RCTs involving 1 659 patients were included. The results of meta-analysis showed that: a) As for the total effective rate, the CTOP (C: cyclophosphamide, T: pirarubicin, O: vincristine, P: prednison) regimen was superior to the CHOP (C: cyclophosphamide H: adriamycin hydrochloride, O: vincristine, P: prednison) regimen with a significant difference (OR=1.07, 95%CI 1.02 to 1.12, P=0.006); and b) As for the safety, there were significant differences between the two groups in the incidence of cardiac toxicity (OR=0.42, 95%CI 0.30 to 0.57, Plt;0.000 01), gastrointestinal tract response (OR=0.69, 95%CI 0.56 to 0.85, P=0.000 5) and liver damage (OR=0.69, 95%CI 0.48 to 1.00, P=0.05). But no significant differences were found between the two groups in the incidence of mye1osuppression: the decreased hemoglobin (OR=0.83, 95%CI 0.61 to 1.14, P=0.25), leucopenia (OR=0.85, 95%CI 0.68 to 1.07, P=0.17), and thrombocytopenia (OR=0.99, 95%CI 0.70 to 1.39, P=0.95). Conclusion Based on the domestic evidences at current and compared with CHOP regimen represented by ADM, CTOP regimen represented by THP for treating NHL shows a higher total effective rate and less side effects. However, more high quality, large sample and double blind RCTs are required to prove this conclusion for the quality and quantity limitation of the included studies.
【摘要】 目的 探讨米卡芬净在有侵袭性真菌感染（invasive fungal infection，IFI）病史的患者行造血干细胞移植（haematopoietic stem cell transplantation，HSCT）时二级预防（secondary anti-fungal prophylaxis，SAP）的有效性和安全性。 方法 选择2009年1月-2011年1月行HSCT治疗血液病患者中有IFI史的18例患者，从预处理进行SAP，13例开始即使用米卡芬净钠，5例开始选用伏立康唑，后换为米卡芬净。预防至危险期结束（白细胞植活、无感染症状），18例患者随访时间62～220 d，中位随访时间为124 d。 结果 米卡芬净治疗有效17例，1例在预防期间+27 d出现真菌突破感染。预防过程中1例在输注的第2天出现躯干充血性皮疹伴瘙痒，经抗过敏治疗后逐渐好转。17例患者在米卡芬净使用过程中未观察严重不良反应发生，也未因此而调整环胞素A治疗浓度。 结论 米卡芬净作为HSCT中SAP的备选用药之一是安全、有效的。【Abstract】 Objective To investigate the efficacy of micafungin on secondary anti-fungal prophylaxis (SAP) in hematopoietie stem cell transplantation (HSCT) recipients who had a history of antecedent invasive fungal infection (IFI) and to observe the safety of micafungin. Methods The patients with hematological diseases，who underwent HSCT between January 2009 and January 2011, received our routine conditioning regimen. The patients, who had a history of antecedent IFI, were given by micafungin for SAP from the start of conditioning chemotherapy until the end of the risk period. Results There were 18 patients had a history of antecedent IFI. The overall efficacy of micafungin was 17/18. One patients had IFI on the +27th day during SAP; one patient had body congestive rash accompanied with pruritus in the prevention period 2 days after treatment, who got better gradually after antianaphylaxis treatment. No patients had server adverse reaction and the concentration of cyclosporine A was not changed. Conclusion Micafungin as one of drugs for SAP Is effective and safe for HSCT.
目的 评价国内干扰素（INF）治疗多发性骨髓瘤（MM）的疗效与安全性。 方法 计算机检索中国期刊全文数据库（1989年－2011年）、中国生物医学文献数据库（1989年-2011年）和中文科技期刊全文数据库（1989年－2011年），并手工检索所有纳入文献的参考文献，纳入INF治疗MM的随机对照试验（RCT）。评价纳入研究的方法学质量并进行资料提取后，采用RevMan 5.0软件进行Meta分析。 结果 共纳入10个RCT，包括366例患者。Meta分析显示，INF联合美法仑+泼尼松（MP） 方案与单用MP方案比较，其总有效率差异有统计学意义[OR=4.52，95% CI（1.84，11.10），P=0.001]；INF联合长春新碱+多柔比星+地塞米松/泼尼松[VAD（P）]与单用VAD（P）方案比较，其总有效率[OR=4.13，95% CI（1.53，11.14），P=0.005]和完全缓解率[OR=3.88，95% CI （1.49，10.16），P=0.006]差异也均有统计学意义；INF+其他化疗方案与单用化疗方案比较，其总有效率[OR=2.57，95%CI（1.11，5.96），P=0.03]和完全缓解率[OR=3.17，95% CI（1.21，8.27），P=0.02]，差异均有统计学意义。 结论 目前国内研究结果表明，INF与化疗联合运用能增加MM治疗的总有效率和缓解率，但由于纳入研究样本量小且质量较低，上述结论尚需要高质量、大样本的随机与双盲对照试验加以分析。