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 |
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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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