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Annals of Hematology

, Volume 97, Issue 10, pp 1941–1950 | Cite as

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

  • 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
Original Article
  • 205 Downloads

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.

Keywords

Mesenchymal stromal cells Graft-versus-host disease Hematopoietic stem cell transplantation Prophylaxis Meta-analysis Randomized controlled trials 

Notes

Funding information

This study was supported by the National Natural Science Foundation of China (nos. 81270642 and 81070451), the Beijing Natural Science Foundation (no. 7162175), the Hainan Social Development Special Funding (no. SF201306), the Four Hundreds Program of Chinese PLA General Hospital (no. YS201451), and the Military Logistics Program (no. cjn15j001).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Supplementary material

277_2018_3384_MOESM1_ESM.docx (2 mb)
ESM 1 (DOCX 2002 kb)

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Li Wang
    • 1
    • 2
  • Cheng-ying Zhu
    • 2
  • De-xun Ma
    • 1
  • Zhen-yang Gu
    • 2
  • Chang-chun Xu
    • 1
  • Fei-yan Wang
    • 2
  • Ji-gang Chen
    • 1
  • Cheng-jun Liu
    • 1
  • Li-xun Guan
    • 2
  • Rui Gao
    • 1
  • Zhe Gao
    • 2
  • Shu Fang
    • 2
  • Du-jun Zhuo
    • 1
  • Shu-feng Liu
    • 1
  • Chun-ji Gao
    • 2
  1. 1.Department of HematologyLaoshan Branch of No. 401 Hospital of Chinese People’s Liberation Army (PLA)QingdaoChina
  2. 2.Department of HematologyChinese People’s Liberation Army (PLA) General HospitalBeijingChina

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