Mesenchymal stromal cells as prophylaxis for graft-versus-host disease in haplo-identical hematopoietic stem cell transplantation recipients with severe aplastic anemia?—a systematic review and meta-analysis

Autor: Jun Shi, Jingke Tu, Liwei Fang, Jingyu Zhao, Hong Pan, Ruonan Li
Jazyk: angličtina
Rok vydání: 2021
Předmět:
medicine.medical_specialty
Severe aplastic anemia
Transplantation Conditioning
medicine.medical_treatment
Mesenchymal stromal cells
Medicine (miscellaneous)
Graft vs Host Disease
Hematopoietic stem cell transplantation
Disease
Mesenchymal Stem Cell Transplantation
Biochemistry
Genetics and Molecular Biology (miscellaneous)
Gastroenterology
Graft-versus-host disease
lcsh:Biochemistry
03 medical and health sciences
0302 clinical medicine
Haplo-identical
Internal medicine
medicine
Humans
lcsh:QD415-436
lcsh:R5-920
business.industry
Incidence (epidemiology)
Research
Mesenchymal stem cell
Hematopoietic Stem Cell Transplantation
Anemia
Aplastic
Mesenchymal Stem Cells
Cell Biology
Odds ratio
medicine.disease
Meta-analysis
030220 oncology & carcinogenesis
Molecular Medicine
Stem cell
lcsh:Medicine (General)
business
030215 immunology
Zdroj: Stem Cell Research & Therapy
Stem Cell Research & Therapy, Vol 12, Iss 1, Pp 1-15 (2021)
ISSN: 1757-6512
Popis: Background Mesenchymal stromal cells (MSCs) are an emerging prophylaxis option for graft-versus-host disease (GVHD) in haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) recipients with severe aplastic anemia (SAA), but studies have reported inconsistent results. This systematic review and meta-analysis evaluates the efficacy of MSCs as prophylaxis for GVHD in SAA patients with haplo-HSCT. Methods Studies were retrieved from PubMed, EMBASE, Cochrane, Web of Science, and http://clinicaltrials.gov from establishment to February 2020. Twenty-nine single-arm studies (n = 1456) were included, in which eight (n = 241) studies combined with MSCs and eleven (n = 1215) reports without MSCs in haplo-HSCT for SAA patients. The primary outcomes were the incidences of GVHD. Other outcomes included 2-year overall survival (OS) and the incidence of cytomegalovirus (CMV) infection. Odds ratios (ORs) were calculated to compare the results pooled through random or fixed effects models. Results Between MSCs and no MSCs groups, no significant differences were found in the pooled incidences of acute GVHD (56.0%, 95% CI 48.6–63.5% vs. 47.2%, 95% CI 29.0–65.4%; OR 1.43, 95% CI 0.91–2.25; p = 0.123), grade II–IV acute GVHD (29.8%, 95% CI 24.1–35.5% vs. 30.6%, 95% CI 26.6–34.6%; OR 0.97, 95% CI 0.70–1.32; p = 0.889), and chronic GVHD (25.4%, 95% CI 19.8–31.0% vs. 30.0%, 95% CI 23.3–36.6%; OR 0.79, 95% CI 0.56–1.11; p = 0.187). Furtherly, there was no obvious difference in 2-year OS (OR 0.98, 95% CI 0.60–1.61; p = 1.000) and incidence of CMV infection (OR 0.61, 95% CI 0.40–1.92; p = 0.018). Conclusions Our meta-analysis indicates that the prophylactic use of MSC co-transplantation is not an effective option for SAA patients undergoing haplo-HSCT. Hence, the general co-transplantation of MSCs for SAA haplo-HSCT recipients may lack evidence-based practice.
Databáze: OpenAIRE
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