SYSTEMATIC REVIEW article
Front. Transplant.
Sec. Cell and Stem Cell Transplantation
Volume 4 - 2025 | doi: 10.3389/frtra.2025.1551820
Hematopoietic Stem Cell Transplantation (HSCT) comparative analysis in Pediatric and Adult Patients: A Systematic Review and Meta-analysis
Provisionally accepted
- 1Washington University in St. Louis, St. Louis, United States
- 2Sanjay Gandhi Post Graduate Institute of Medical Sciences (SGPGI), Lucknow, Uttar Pradesh, India
- 3University of Delhi, New Delhi, National Capital Territory of Delhi, India
- 4National Institute of Pharmaceutical Education and Research, Raebareli, Uttar Pradesh, India
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Introduction: Hematopoietic stem cell transplantation (HSCT) is known as a significant treatment option for Acute Myeloid Leukemia (AML). However, some important inquiries remain left related to its efficacy and safety, specifically when administered to various age cohorts within the pediatric and adult patients. Aim: To investigate the efficacy of HSCT in treating pediatric patients compared to adult patients diagnosed with AML Methods: A systematic search was conducted in Pubmed, Scopus, Google Scholar, and Medline for studies published in the English language from inception to 2023. The finding was reported by the PRISMA checklist. Statistical analysis was conducted using Cochrane's software (Rev Man) version 5.4, which used random and fixed effect models when necessary. Results: Fourteen studies met the criteria for meta-analysis. The results indicate a slightly positive trend in overall survival with pediatrics and combined pediatric-adult groups compared to adults alone, although the differences were not statistically significant. For relapse rate, no significant differences were observed in the adult and pediatric groups individually, while the combined pediatric-adult group showed a substantial benefit from HSCT (OR: 2.3, p-value -0.05). A similar trend was observed in disease-free survival, where the combined group showed a modest, though not statistically significant, improvement with HSCT. While with treatment-related mortality, a statistically protective effect of HSCT was observed in the adult group (OR: 0.26, p= 0.0005), while the pediatric and combined groups did not show significant effects. For graft-versus-host disease (GvHD), a significant association with HSCT was found in the pediatric group (OR: 2.58, p = 0.03), while the adult and combined groups showed no significant effects.Our analysis showed mixed results, showing a slightly better effect of hematopoietic stem cell transplantation (HSCT) in treating pediatric patients diagnosed with acute myeloid leukemia (AML) than adults.
Keywords: AML- Acute Myeloid Leukemia, HSCT- Hematopoietic Stem Cell Transplantation, RR- Relapse Rate, GVHD- Graft-Versus-Host Disease, TRM- Treatment-Related Mortality, OS- Overall Survival, DFS- Disease-Free Survival
Received: 26 Dec 2024; Accepted: 09 May 2025.
Copyright: © 2025 Maurya, Sagar, Chaturvedi, Pandey and Kushwaha. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Shailendra Shanker Maurya, Washington University in St. Louis, St. Louis, United States
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