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Comparison of pegaspargase and Lsparaginase in treatment of Chinese children with acute lymphoblasfic leukemia: a meta analysis

  

  1. Department of Pediatrics,  Fujian Medical University Union Hospital,  Fuzhou 350001,  China
  • Online:2018-02-05 Published:2018-02-11
  • Contact: Corresponding author: Chen Yanhui, Email: yanhui_0655@ 126.com

Abstract: Objective  To evaluate the efficacy, safety and pharmacoeconmics between pegaspargase(PEGasp) and Lsparaginase(Lasp)  in treatment of Chinese children with acute lymphoblasfic leukemia. Methods  CNKI, Wanfang, VIP, PubMed and OVID databases were searched to collect RCTs which compared PEGasp with Lasp in treatment of Chinese children with acute lymphoblasfic leukemia, and the retrieval time was until March, 2017. Metaanalysis was conducted by Revman 5.3 software. Results  Finally, five RCTs were included in this study. A total of 544 children with ALL were enrolled, including 272 patients in PEGasp group and 272 patients in Lasp group. ①The metaanalysis showed that the complete remission CR) rate and the total response (RR) rate between the two therapy groups were similar. Compared to Lasp group, the OR of the CR rate of PEGasp group was 0.85 (95%CI=0.551.34,P>0.05); and the RR of the CR rate was 1.35 (95%CI=0.632.90,P>0.05). ② All five articles reported the occurrence of adverse reaction. In each study,  the occurrence rate of adverse reaction between the two therapy groups was no statistically significant difference. ③In three articles, the hospitalized days and the number of drugs between the two therapy groups were compared. The metaanalysis of the hospitalized days between the two therapy groups showed that the hospitalized days of  PEGasp group was significantly shorter than that in Lasp group (WMD: -6.60, 95%CI=-7.99   to  -5.22). Conclusion  The effectiveness of PEGasp and Lasp in treatment of pediatric ALL is similar and has no difference in adverse effect. However, PEGasp may be a better choice from the point of view of pharmacoeconmics.

Key words: leukemia, lymphoid;chidlren; , pegaspargase, metaanalysis