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Review
. 2021 Nov;21(4):537-543.
doi: 10.1007/s10238-021-00712-0. Epub 2021 Apr 17.

Meta-analysis of the benefit of hypomethylating agents before allogeneic hematopoietic stem cell transplantation in myelodysplastic syndromes

Liu Liu #  1 , Menglu Jia #  2 , Ling Sun  2 , Wenliang Tian  2 , Ping Tang  2 , Zhongxing Jiang  2
Affiliations
Review

Meta-analysis of the benefit of hypomethylating agents before allogeneic hematopoietic stem cell transplantation in myelodysplastic syndromes

Liu Liu et al. Clin Exp Med. 2021 Nov.

Abstract

Hypomethylating agents (HMAs) are effective therapies in myelodysplastic syndromes (MDS), but allogeneic hematopoietic stem cell transplantation (allo-HSCT) is the only way to cure MDS. According to the current literature, it is difficult to confirm whether HMAs bridging therapy is beneficial for MDS patients receiving allo-HSCT. Therefore, we tried to evaluate the effect of HMAs on long-term survival of the MDS patients. Databases, including PubMed, Embase Ovid, and the Cochrane Library, were searched for studies published up to January 10, 2021. Patients who accepted HMAs bridging to allo-HSCT were defined as experimental group, while patients who received the best supportive care (BSC) before allo-HSCT were control group. Overall survival (OS) was the primary end point. Seven studies were included in the final analysis. The final results showed no OS differences between patients accepted HMAs before allo-HSCT and those received BSC (HR = 0.86, 95% CI: 0.64-1.15, p = 0.32), indicating that MDS patients' long-term survival did not benefit from HMAs bridging therapy before allo-HSCT. This conclusion needs to be further verified by a large number of prospective randomized controlled trials, which have guiding significance for the treatment of MDS patients.

Keywords: Allogeneic hematopoietic stem cell transplantation; Hypomethylating agents; Meta-analysis; Myelodysplastic syndromes.

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Conflict of interest statement

The authors have no conflicts of interest to declare that are relevant to the content of this article.

Figures

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Risk of research bias
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Summary of research bias risk
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Study selection flowchart
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Forest plots
See this image and copyright information in PMC

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