Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis
The present study aimed to compare the efficacy and safety of hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy (IST) for hepatitis-associated aplastic anemia (HAAA). Studies comparing HSCT with IST in HAAA were retrieved from inception to July 22, 2024, including 12 studi...
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| Format: | Article |
| Language: | English |
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Taylor & Francis Group
2025-12-01
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| Series: | Hematology |
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| Online Access: | https://www.tandfonline.com/doi/10.1080/16078454.2025.2548990 |
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| author | Yaonan Hong Qi Liu Zhuonan Sun Peicheng Wang Xu Wang Ziying Su Yuzhu Li Wenbin Liu Huijin Hu Yingying Shen Baodong Ye Yuhong Zhou Shan Liu Dijiong Wu |
| author_facet | Yaonan Hong Qi Liu Zhuonan Sun Peicheng Wang Xu Wang Ziying Su Yuzhu Li Wenbin Liu Huijin Hu Yingying Shen Baodong Ye Yuhong Zhou Shan Liu Dijiong Wu |
| author_sort | Yaonan Hong |
| collection | DOAJ |
| description | The present study aimed to compare the efficacy and safety of hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy (IST) for hepatitis-associated aplastic anemia (HAAA). Studies comparing HSCT with IST in HAAA were retrieved from inception to July 22, 2024, including 12 studies with a total of 544 cases for meta-analysis. Meta-analysis demonstrated significantly superior outcomes in the HSCT group versus IST, which was manifested as lower overall mortality (P < 0.01), higher overall response rate (P < 0.001), and improved five-year overall survival (P < 0.05), yielding a pooled RR of 1.67 (95% CI: 1.15–2.44), 0.75 (95% CI: 0.66–0.86) and 0.88 (95% CI: 0.78–0.99), respectively. However, no benefit was observed in one-year survival (P = 0.08). Further subgroup analysis indicated that the advantage of mortality (P < 0.05, RR = 1.67, 95% CI: 1.10–2.55) and five-year overall survival (P = 0.05, RR = 0.84, 95% CI: 0.71–1.00) only achieved in patients under 20 years old. There was no significant difference in the overall response and one-year overall survival for each age group. Additionally, for the IST selection, a combination of cyclosporine (CSA) and antithymocyte globulin/antilymphocyte globulin (ATG/ALG) was preferred over the CSA-only regimen (effectiveness of 78.57% vs. 50.00%), although the difference was not statistically significant (P = 0.10, RR = 1.56, 95% CI: 0.92–2.66). This study showed that HSCT had a higher effective rate, greater long-term survival and lower mortality compared to IST, especially for patients under 20 years old, who should receive HSCT treatment as possible. |
| format | Article |
| id | doaj-art-98356f39911f4b62bb8a7fecbdc9e8a2 |
| institution | Kabale University |
| issn | 1607-8454 |
| language | English |
| publishDate | 2025-12-01 |
| publisher | Taylor & Francis Group |
| record_format | Article |
| series | Hematology |
| spelling | doaj-art-98356f39911f4b62bb8a7fecbdc9e8a22025-08-26T08:28:44ZengTaylor & Francis GroupHematology1607-84542025-12-0130110.1080/16078454.2025.2548990Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysisYaonan Hong0Qi Liu1Zhuonan Sun2Peicheng Wang3Xu Wang4Ziying Su5Yuzhu Li6Wenbin Liu7Huijin Hu8Yingying Shen9Baodong Ye10Yuhong Zhou11Shan Liu12Dijiong Wu13The First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe First School of Clinical Medicine, Zhejiang Chinese Medical University, Hangzhou, People’s Republic of ChinaThe present study aimed to compare the efficacy and safety of hematopoietic stem cell transplantation (HSCT) and immunosuppressive therapy (IST) for hepatitis-associated aplastic anemia (HAAA). Studies comparing HSCT with IST in HAAA were retrieved from inception to July 22, 2024, including 12 studies with a total of 544 cases for meta-analysis. Meta-analysis demonstrated significantly superior outcomes in the HSCT group versus IST, which was manifested as lower overall mortality (P < 0.01), higher overall response rate (P < 0.001), and improved five-year overall survival (P < 0.05), yielding a pooled RR of 1.67 (95% CI: 1.15–2.44), 0.75 (95% CI: 0.66–0.86) and 0.88 (95% CI: 0.78–0.99), respectively. However, no benefit was observed in one-year survival (P = 0.08). Further subgroup analysis indicated that the advantage of mortality (P < 0.05, RR = 1.67, 95% CI: 1.10–2.55) and five-year overall survival (P = 0.05, RR = 0.84, 95% CI: 0.71–1.00) only achieved in patients under 20 years old. There was no significant difference in the overall response and one-year overall survival for each age group. Additionally, for the IST selection, a combination of cyclosporine (CSA) and antithymocyte globulin/antilymphocyte globulin (ATG/ALG) was preferred over the CSA-only regimen (effectiveness of 78.57% vs. 50.00%), although the difference was not statistically significant (P = 0.10, RR = 1.56, 95% CI: 0.92–2.66). This study showed that HSCT had a higher effective rate, greater long-term survival and lower mortality compared to IST, especially for patients under 20 years old, who should receive HSCT treatment as possible.https://www.tandfonline.com/doi/10.1080/16078454.2025.2548990Hepatitis-associated aplastic anemiaHematopoietic stem cell transplantationImmunosuppressive therapyMeta-analysis |
| spellingShingle | Yaonan Hong Qi Liu Zhuonan Sun Peicheng Wang Xu Wang Ziying Su Yuzhu Li Wenbin Liu Huijin Hu Yingying Shen Baodong Ye Yuhong Zhou Shan Liu Dijiong Wu Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis Hematology Hepatitis-associated aplastic anemia Hematopoietic stem cell transplantation Immunosuppressive therapy Meta-analysis |
| title | Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis |
| title_full | Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis |
| title_fullStr | Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis |
| title_full_unstemmed | Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis |
| title_short | Efficacy and safety of hematopoietic stem cell transplantation vs. immunosuppressive therapy in patients with hepatitis-associated aplastic anemia: a systematic review and meta-analysis |
| title_sort | efficacy and safety of hematopoietic stem cell transplantation vs immunosuppressive therapy in patients with hepatitis associated aplastic anemia a systematic review and meta analysis |
| topic | Hepatitis-associated aplastic anemia Hematopoietic stem cell transplantation Immunosuppressive therapy Meta-analysis |
| url | https://www.tandfonline.com/doi/10.1080/16078454.2025.2548990 |
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