Clinical efficacy and safety of thalidomide combined with conventional chemotherapy in treatment of acute leukemia: a Meta analysis / 白血病·淋巴瘤

ABSTRACT

Objective To analyze the clinical efficacy and safety of thalidomide combined with conventional chemotherapy in treatment of acute leukemia by using Meta analysis. Methods Thalidomide combined with conventional chemotherapy was treated as the experiment group, chemotherapy alone was treated as the control group. Thalidomide was taken 100mg once a day, oral administration. The literatures were retrieved from PubMed, Cochrane library, Embase, China Notional Knowledge Infrastructure (CNKI), Wanfang and VIP database. The data of the randomized controlled trial (RCT) conformed to inclusion criteria were extracted, and the quality was evaluated, and then StataMP 14.0 software was used to make a Meta analysis. Results A total of 14 studies with 752 patients were included. The experiment group had a higher complete remission rate and the overall response rate compared with the control group, and the difference was statistically significant (RR ＝ 1.61, 95% CI 1.36-1.90, P< 0.01; RR＝ 1.36, 95% CI 1.24-1.50, P< 0.01). The experiment group had a better efficacy in the improvement of vascular endothelial growth factor (VEGF), VEGF receptor (VEGFR), basic fibroblast growth factor (bFGF) and bone marrow microvessel density (MVD) after the treatment compared with the control group, and the differences between the two groups were statistically significant (all P <0.05), but there was no significant difference in the adverse events between the two groups (all P＞0.05). Conclusion Meta analysis showed that oral administration daily thalidomide 100 mg combined with conventional chemotherapy has a better clinical efficacy and antiangiogenic effect compared with chemotherapy alone, without the increase of adverse reactions.