PMID- 33879242 OWN - NLM STAT- MEDLINE DCOM- 20210712 LR - 20210712 IS - 1757-6512 (Electronic) IS - 1757-6512 (Linking) VI - 12 IP - 1 DP - 2021 Apr 20 TI - Efficacy and safety of mesenchymal stem cells co-infusion in allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis. PG - 246 LID - 10.1186/s13287-021-02304-x [doi] LID - 246 AB - BACKGROUND: Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is life-saving for severe hematological conditions. However, its outcomes need further improvement, and co-infusion of mesenchymal stem cells (MSCs) may show promise. A growing body of research on this subject exists, while the results of different trials are conflicting. A systematic review and meta-analysis is needed to appraise the real efficacy and safety of MSC co-transplantation in allo-HSCT. METHODS: Studies comparing MSC co-transplantation in allo-HSCT with allo-HSCT alone were searched in six medical databases from inception to June 10, 2020. The primary outcomes were engraftment and graft-versus-host disease (aGVHD and cGVHD, respectively). Other outcomes included overall survival (OS), relapse rate (RR), non-relapse mortality (NRM), and immune reconstitution. Information was independently extracted by two investigators. Methodological quality was assessed using the Cochrane Collaboration tool. Meta-analysis was performed using RevMan 5.4. RESULTS: Six randomized controlled trials (RCTs) and 13 non-randomized controlled trials (nRCTs) were included. MSC co-infusion resulted in shorter times to neutrophil engraftment (RCTs: standardized mean difference (SMD) - 1.20, p = 0.04; nRCTs: SMD - 0.54, p = 0.04) and platelet engraftment (RCTs: SMD - 0.60, p = 0.04; nRCTs: SMD - 0.70, p = 0.01), a lower risk of cGVHD (RCTs: risk ratio (RR) 0.53, p = 0.01; nRCTs: RR 0.50, p < 0.01), and a slightly positive trend towards reducing the risk of aGVHD and NRM, without affecting RR and OS. Subgroup analyses revealed that when MSCs were co-transplanted, children and adolescents, and patients receiving human leukocyte antigen (HLA)-nonidentical HSCT showed improvements in engraftment and incidence of GVHD and NRM; adults and patients who received HLA-identical HSCT had lower cGVHD; patients with malignancies exhibited improvements in GVHD and NRM incidence; and patients with non-malignancies experienced accelerated engraftment. Notably, a reduced OS was observed in patients with hematological malignancies undergoing HLA-identical HSCT. CONCLUSION: MSC co-infusion generally improved engraftment and reduced cGVHD, without increasing mortality or relapse. Regarding aGVHD and NRM, the effects of MSCs were not quite significant. Specifically, our data support the utilization of MSC co-transplantation in children and young individuals with HLA-nonidentical HSCT, but not in adult patients with hematological malignancies undergoing HLA-identical HSCT. FAU - Li, Teng AU - Li T AD - Center for Hematology, Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. AD - Admin Office of Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. FAU - Luo, Chengxin AU - Luo C AD - Center for Hematology, Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. FAU - Zhang, Jiasi AU - Zhang J AD - Center for Hematology, Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. FAU - Wei, Ling AU - Wei L AD - Center for Hematology, Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. FAU - Sun, Wei AU - Sun W AD - Teaching-Research Office of Nursing, Southwest Hospital, Army Medical University (Third Military Medical University), Chongqing, People's Republic of China. FAU - Xie, Qin AU - Xie Q AD - School of Nursing, Army Medical University (Third Military Medical University), Chongqing, People's Republic of China. FAU - Liu, Yan AU - Liu Y AD - School of Nursing, Army Medical University (Third Military Medical University), Chongqing, People's Republic of China. FAU - Zhao, Yongli AU - Zhao Y AD - Center for Hematology, Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. FAU - Xu, Shuangnian AU - Xu S AD - Center for Hematology, Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. xushuangnian@tmmu.edu.cn. FAU - Wang, Lihua AU - Wang L AD - Admin Office of Southwest Hospital, Army Medical University (Third Military Medical University), #30 Gaotanyan Street, Shapingba District, Chongqing, 400038, People's Republic of China. 773569612@qq.com. LA - eng PT - Journal Article PT - Meta-Analysis PT - Research Support, Non-U.S. Gov't PT - Systematic Review DEP - 20210420 PL - England TA - Stem Cell Res Ther JT - Stem cell research & therapy JID - 101527581 SB - IM MH - Adolescent MH - Adult MH - Child MH - *Graft vs Host Disease MH - *Hematologic Neoplasms MH - *Hematopoietic Stem Cell Transplantation/adverse effects MH - Humans MH - *Mesenchymal Stem Cell Transplantation/adverse effects MH - *Mesenchymal Stem Cells MH - Neoplasm Recurrence, Local PMC - PMC8056684 OTO - NOTNLM OT - Engraftment OT - Graft-versus-host disease OT - Hematopoietic stem cell transplantation OT - Mesenchymal stem cells COIS- The authors declare that they have no competing interests. EDAT- 2021/04/22 06:00 MHDA- 2021/07/13 06:00 PMCR- 2021/04/20 CRDT- 2021/04/21 05:45 PHST- 2021/02/04 00:00 [received] PHST- 2021/03/22 00:00 [accepted] PHST- 2021/04/21 05:45 [entrez] PHST- 2021/04/22 06:00 [pubmed] PHST- 2021/07/13 06:00 [medline] PHST- 2021/04/20 00:00 [pmc-release] AID - 10.1186/s13287-021-02304-x [pii] AID - 2304 [pii] AID - 10.1186/s13287-021-02304-x [doi] PST - epublish SO - Stem Cell Res Ther. 2021 Apr 20;12(1):246. doi: 10.1186/s13287-021-02304-x.