{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T16:37:48Z","timestamp":1793119068696,"version":"4.5.0"},"reference-count":67,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T00:00:00Z","timestamp":1760486400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Both hematopoietic stem cell transplantation (HSCT) and chemotherapy combined with tyrosine kinase inhibitors (TKIs) have shown therapeutic efficacy in patients with Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL). This study aimed to compare the clinical outcomes of HSCT and TKI-combined chemotherapy regimens in Ph+ ALL through a meta-analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We systematically searched PubMed (from 1966), Embase (from 1974), and the Cochrane Library (from 1993) up to April 30, 2025, for eligible studies. Overall survival (OS) and disease-free survival (DFS) were evaluated using hazard ratios (HRs) with 95% confidence intervals (CIs), while relapse risk was assessed using odds ratios (ORs) with 95%CIs. A random-effects model was applied for all analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The meta-analysis included 35 studies involving 3,827 patients with Ph+ ALL. Allogeneic HSCT (allo-HSCT) was associated with significantly better OS (HR: 0.60; 95% CI: 0.45\u20130.81; <jats:italic>P<\/jats:italic> = 0.001) and DFS (HR: 0.40; 95% CI: 0.30\u20130.54; <jats:italic>P<\/jats:italic> &amp;lt; 0.001) compared to TKI-based chemotherapy. No significant differences in OS (HR: 0.97; 95% CI: 0.70\u20131.34; <jats:italic>P<\/jats:italic> = 0.845) or DFS (HR: 0.92; 95% CI: 0.67\u20131.26; <jats:italic>P<\/jats:italic> = 0.605) were observed between allo-HSCT and autologous HSCT (auto-HSCT). Moreover, allo-HSCT was associated with a significantly lower relapse risk than both TKI-based chemotherapy (OR: 0.28; 95% CI: 0.16\u20130.51; <jats:italic>P<\/jats:italic> &amp;lt; 0.001) and auto-HSCT (OR: 0.39; 95% CI: 0.27\u20130.54; <jats:italic>P<\/jats:italic> &amp;lt; 0.001).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>This meta-analysis demonstrates that allo-HSCT provides superior survival outcomes compared to TKI-based chemotherapy in patients with Ph+ ALL. Although survival outcomes are similar between allo-HSCT and auto-HSCT, allo-HSCT is associated with a significantly reduced risk of relapse.<\/jats:p><\/jats:sec><jats:sec><jats:title>Systematic Review Registration<\/jats:title><jats:p><jats:uri>https:\/\/www.crd.york.ac.uk\/prospero\/<\/jats:uri>, identifier INPLASY202550012.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2025.1627825","type":"journal-article","created":{"date-parts":[[2025,10,15]],"date-time":"2025-10-15T04:24:58Z","timestamp":1760502298000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Comparing therapeutic effects of hematopoietic stem cell transplantation, tyrosine kinase inhibitors and chemotherapy in adult patients with Philadelphia chromosome-positive acute lymphoblastic leukemia: a systematic review and meta-analysis"],"prefix":"10.3389","volume":"15","author":[{"given":"Xiaohui","family":"Gao","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Zeng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fei","family":"Sun","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyan","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Haibing","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Minchao","family":"Yan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qinyan","family":"Fu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gang","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2025,10,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2113347","article-title":"Philadelphia 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