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01-10-2018 | Original Article

Efficacy and safety of mesenchymal stromal cells for the prophylaxis of chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials

Authors: Li Wang, Cheng-ying Zhu, De-xun Ma, Zhen-yang Gu, Chang-chun Xu, Fei-yan Wang, Ji-gang Chen, Cheng-jun Liu, Li-xun Guan, Rui Gao, Zhe Gao, Shu Fang, Du-jun Zhuo, Shu-feng Liu, Chun-ji Gao

Published in: Annals of Hematology | Issue 10/2018

Abstract

A meta-analysis of randomized controlled trials (RCTs) was conducted to evaluate the efficacy and safety of mesenchymal stromal cells (MSCs) for the prophylaxis of chronic graft-versus-host disease (cGVHD) in patients with hematological malignancies undergoing allogeneic hematopoietic stem cell transplantation (allo-HSCT). Six studies involving 365 patients were included. The pooled results showed that MSCs significantly reduced the incidence of cGVHD (risk ratio [RR] 0.63, 95% confidence interval [CI] 0.46 to 0.86, P = 0.004). Favorable prophylactic effects of MSCs on cGVHD were observed with umbilical cord-derived, high-dose, and late-infusion MSCs, while bone marrow-derived, low-dose, and coinfused MSCs did not confer beneficial prophylactic effects. In addition, MSC infusion did not increase the risk of primary disease relapse and infection (RR 1.02, 95% CI 0.70 to 1.50, P = 0.913; RR 0.89, 95% CI 0.44 to 1.81, P = 0.752; respectively). Moreover, there was an apparent trend toward increased overall survival (OS) in the MSC group compared with that in the control group (RR 1.13, 95% CI 0.98 to 1.29, P = 0.084). In conclusion, this meta-analysis demonstrated that MSC infusion is an effective and safe prophylactic strategy for cGVHD in patients with hematological malignancies undergoing allo-HSCT.

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Title: Efficacy and safety of mesenchymal stromal cells for the prophylaxis of chronic graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: a meta-analysis of randomized controlled trials
Authors: Li Wang
Cheng-ying Zhu
De-xun Ma
Zhen-yang Gu
Chang-chun Xu
Fei-yan Wang
Ji-gang Chen
Cheng-jun Liu
Li-xun Guan
Rui Gao
Zhe Gao
Shu Fang
Du-jun Zhuo
Shu-feng Liu
Chun-ji Gao
Publication date: 01-10-2018
Publisher: Springer Berlin Heidelberg
Published in: Annals of Hematology / Issue 10/2018
Print ISSN: 0939-5555
Electronic ISSN: 1432-0584
DOI: https://doi.org/10.1007/s00277-018-3384-8

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