Conventional therapy vs HMA or LDAC with or without venetoclax in older adults with AML: systematic review and meta-analysis.

We searched Ovid MEDLINE and Embase, and Cochrane CENTRAL through February 2024, and monitored these databases for new studies throughout November 2024.

我们在2024年2月之前通过Ovid MEDLINE和Embase以及Cochrane CENTRAL进行了搜索，并在整个2024年11月期间监测这些数据库以发现新的研究。

We included randomized controlled trials (RCTs) and nonrandomized studies (NRS).

我们纳入了随机对照试验(RCTs)和非随机研究(NRS)。

Reviewers screened studies, extracted data, assessed risk of bias, conducted random-effects meta-analyses, and rated certainty of evidence using GRADE (grading of recommendations, assessment, development, and evaluation).

审查员筛选研究，提取数据，评估偏倚风险，进行随机效应的荟萃分析，并使用GRADE（推荐等级的评估、制定与评价）评定证据的确定性。

We included 21 studies (3 RCTs, 18 NRS).

我们纳入了21项研究（3项随机对照试验，18项非随机研究）。

Compared with HMA- or LDAC-based monotherapy, conventional 7+3-type remission induction therapy may reduce mortality at longest follow-up (risk ratio [RR], 0.94; 95% confidence interval[CI], 0.85-1.04; low certainty), increase complete remission rates (odds ratio, 1.75; 95% CI, 1.25-2.38; high certainty), and may reduce recurrence at longest follow-up (RR, 0.81; 95% CI, 0.64-1.04; low certainty).

与HMA或LDAC为基础的单药治疗相比，传统的7+3型缓解诱导治疗可能在最长随访时降低死亡率（风险比[RR]，0.94；95%置信区间[CI]，0.85-1.04；低确定性），提高完全缓解率（优势比，1.75；95% CI，1.25-2.38；高确定性），并且可能在最长随访时降低复发率（RR，0.81；95% CI，0.64-1.04；低确定性）。

Conventional therapies probably increase most severe toxicities (moderate certainty).

传统疗法可能会增加大多数严重毒性（中等确定性）。

Compared with HMA or LDAC combined with venetoclax, very low certainty evidence suggests that conventional therapy may reduce 1-year mortality (RR, 0.72; 95% CI, 0.60-0.87), increase allogeneic transplant rates (RR, 2.28; 95% CI, 1.70-3.06), result in no important differences in complete remission or recurrence, and have variable effects on severe toxicities.

与HMA或LDAC联合维奈克拉相比，非常低的证据表明传统疗法可能会降低1年死亡率（RR，0.72；95%置信区间，0.60-0.87），增加异基因移植率（RR，2.28；95%置信区间，1.70-3.06），在完全缓解或复发方面没有重要差异，并且对严重毒性的影响不一。

Conventional therapy may have benefits over HMA or LDAC alone; however, compared with HMA or LDAC plus venetoclax, the evidence remains of very low certainty.

传统治疗可能比单独使用HMA或LDAC更有益；然而，与HMA或LDAC联合使用venetoclax相比，证据的确定性仍然非常低。