伴TP53突变的急性髓系白血病或骨髓增生异常综合征患者异基因造血干细胞移植后1～5年总生存率的Meta分析OA

Objective To systematically evaluate the 1-5 year overall survival outcomes among patients with TP53-mutated acute myeloid leukemia(AML)or myelodysplastic syndromes(MDS)following allogene-ic hematopoietic stem cell transplantation(allo-HSCT).Methods The Cochrane Library,PubMed,Embase,Wanfang Data and China National Knowledge Infrastructure(CNKI)databases were searched for studies re-porting survival outcomes after allo-HSCT in patients with TP53-mutated AML or MDS.All databases were searched from inception to June 1,2025.The primary outcomes were the 1-,2-,3-,4-,and 5-year overall sur-vival rates after transplantation.Overall survival rates and their 95%confidence intervals(95%CI)at each time point were pooled using Meta-analysis,and subgroup analyses were performed according to disease type.Results Eleven retrospective cohort studies involving 515 patients were included.The pooled 1-year overall survival rates after allo-HSCT were 39%(95%CI:34%-44%;P=0.003)for patients with TP53-mutated MDS and 55%(95%CI:47%-62%;P<0.001)for patients with TP53-mutated AML.The corresponding pooled 2-year overall survival rates were 29%(95%CI:24%-33%;P=0.004)and 27%(95%CI:21%-33%;P<0.001),respectively.The pooled 3-year overall survival rates were 20%(95%CI:16%-24%;P<0.001)and 19%(95%CI:12%-26%;P=0.002),respectively.The pooled 4-year overall survival rates were 18%(95%CI:14%-22%;P<0.001)and 17%(95%CI:10%-24%;P<0.001),respectively.The pooled 5-year overall survival rates were 20%(95%CI:16%-24%;P=0.022)and 9%(95%CI:2%-17%;P=0.827),respectively.Conclusion Although some patients may achieve long-term survival after allo-HSCT,o-verall long-term survival rates remain low,and improving long-term outcomes remains a major challenge.