异基因造血干细胞移植治疗侵袭性 NK 细胞白血病的疗效与预后：一项荟萃分析

Aggressive NK-cell leukemia (ANKL) is a rare and highly malignant lymphoproliferative disorder associated with poor prognosis and high mortality rates. The disease is closely linked to Epstein-Barr virus (EBV) and predominantly affects populations in Asia and Latin America. Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has emerged as a promising treatment strategy, yet its efficacy and prognosis in ANKL patients remain to be systematically evaluated.

We conducted a systematic review and meta-analysis by searching PubMed, Embase, Web of Science, and the Cochrane Library for studies published up to April 2025. The objective was to evaluate the outcomes of allo-HSCT in patients with ANKL. Six studies met the inclusion criteria. The primary outcomes included overall survival (OS) and progression-free survival (PFS), reported as hazard ratios (HRs), as well as standardized mean differences (SMDs) and median follow-up times for survivors (reported in months with ranges). Depending on the degree of heterogeneity-assessed using the I 2 statistic-random-effects or fixed-effects models were applied. Sensitivity analyses were conducted by sequentially excluding individual studies, and publication bias was assessed using funnel plots.

Based on the analysis, a total of six studies comprising 295 ANKL patients who underwent allo-HSCT were included. The SMD for the median follow-up duration among survivors was 1. 21 (95% CI: 0. 39-2. 02), indicating notable variation in follow-up times across studies. Heterogeneity for this outcome was minimal, with an I 2 of 0% and a p-value of 0. 6621. Regarding the effect of allo-HSCT on overall survival, the pooled HR was 0.

47 (95% CI: 0. 32-0. 68), demonstrating a statistically significant survival benefit associated with the procedure. Heterogeneity in this analysis was also low (I 2 = 0. 0%, p = 0. 684), reflecting strong consistency across the included studies. For PFS, the pooled HR was 0. 22 (95% CI: 0. 12-0. 40), again indicating a significant improvement in outcomes.

However, moderate heterogeneity was observed in this analysis (I 2 = 68. 4%, p = 0. 032). Funnel plot analysis revealed no significant evidence of publication bias, suggesting that the included data were robust and not substantially affected by selective reporting. This meta-analysis demonstrates that allo-HSCT significantly improves survival outcomes in patients with ANKL. The pooled hazard ratio of 0. 47 indicates a favorable impact on overall survival.

Additionally, the median survival time among survivors is notably longer, further supporting the efficacy of allo-HSCT. These results highlight the potential of allo-HSCT as a promising therapeutic strategy for ANKL, emphasizing the need for continued research to refine treatment protocols and enhance patient outcomes.