scholarly journals Prophylactic donor lymphocyte infusion for relapse prevention: a meta-analysis

2020 ◽  
Vol 50 (6) ◽  
pp. 661-670
Author(s):  
Kittika Poonsombudlert ◽  
Jakrin Kewcharoen ◽  
Chattip Prueksapraopong ◽  
Nath Limpruttidham
Keyword(s):  
Relapse Prevention ◽  
Meta Analysis ◽  
Random Effect ◽  
Donor Lymphocyte Infusion ◽  
Cochrane Library ◽  
Control Group ◽  
Cell Transplant ◽  
Hematopoietic Stem ◽  
Graft Versus Host ◽  
Donor Lymphocytes

Abstract Objective Primary disease relapse (PDR) of malignant hematologic conditions after standard hematopoietic stem cell transplant (HSCT) is one of the most challenging diseases; therefore ongoing researches are aiming at relapse prevention and minimizing the transplant-related side effects. Prophylactic donor lymphocytes (pDLI) had been proposed as a valuable strategy for PDR prevention, but early studies had been discouraging due to the limited benefit and possible association with acute graft-versus-host disease (aGVHD). Therefore, we conducted a meta-analysis to evaluate the association between pDLI use, PDR, aGVHD and OS. Method We performed a comprehensive literature search in MEDLINE, Cochrane library and Embase database from inception to May 2019 for studies that evaluated the association between pDLI and PDR. We conducted a random effect meta-analysis of 9 studies involving a total of 748 participants (pDLI = 398, non-pDLI = 350) and reported the pooled odd ratio (OR) for association of pDLI use, PDR, aGVHD and OS. Result We found a significant decreased odd of PDR in the pDLI group (pooled OR = 0.42, 95% CI 0.30–0.58, I2 = 0%), but there was no significant increased odd of aGVHD (pooled OR of 0.98, 95% CI 0.56–1.72, I2 = 0.8%). We also found that there was an increased odd of overall survival (OS) (pooled OR 3.17, 95% CI 1.85–5.45, I2 = 50.2%). Conclusion There are significantly decreased odd of PDR and increased odd of OS in the pDLI group compared to the control group, but there is no statistically significant increased odd of aGVHD as suggested by previous studies. We concluded that pDLI is a potentially valuable method for post-transplant PDR prevention.

scholarly journals Prophylactic Donor Lymphocyte Infusion for Relapse Prevention; A Meta-Analysis

Blood ◽  
2019 ◽  
Vol 134 (Supplement_1) ◽  
pp. 2017-2017
Author(s):  
Kittika Poonsombudlert ◽  
Jakrin Kewcharoen ◽  
Chattip Prueksapraopong ◽  
Limpruttidham Nath
Keyword(s):  
Relapse Prevention ◽  
Meta Analysis ◽  
Hematologic Malignancies ◽  
Cochrane Library ◽  
Control Group ◽  
Cell Transplant ◽  
Ongoing Research ◽  
Hematopoietic Stem ◽  
Study Results ◽  
Risk Of Relapse

Objective: relapsed hematologic malignancies after standard hematopoietic stem cell transplant (HSCT) is one of the most challenging diseases to treat, therefore ongoing research are aiming at relapse prevention and minimizing the transplant related side effects. Prophylactic donor lymphocytes (pDLI) had been proposed as a valuable strategy for relapse prevention but early study results had been discouraging due to association with acute graft-versus-host disease (aGVHD). We attempted to establish the efficacy of pDLI for relapse prevention and define its association with aGVHD. Method: we searched for titles of articles in MEDLINE (PubMed), Cochrane library, EMBASE database and Google Scholar in May 2019 that evaluated the association between pDLI, relapse and aGVHD. We conducted a random effect meta-analysis of 9 studies involving a total of 748 participants and reported the pooled odd ratio (OR) for incidence of relapse and aGVHD between patients in the pDLI group and the control group. Result: we found a significantly decreased risk of relapse in the pDLI group versus the control group with a pooled OR of 0.42, 95% CI 0.30-0.58, I2=0% while there is no significantly increased in the risk of aGVHD with a pooled OR of 0.98, 95% CI 0.56-1.72, I2=0.8% Conclusion: there is significantly decreased risk of relapse in the pDLI group compared to the control group but there is no statistically significant increased risk of aGVHD. We concluded that pDLI is a valuable method of post-transplant relapse prevention for hematologic malignancies and further research is encouraged in a larger population. Disclosures No relevant conflicts of interest to declare.

scholarly journals A Meta-Analysis of the Efficacy of Panax Ginseng on Menopausal Women’s Sexual Function

2018 ◽  
Vol 7 (1) ◽  
pp. 124-133 ◽  
Author(s):  
Zahra Ghorbani ◽  
Mojgan Mirghafourvand
Keyword(s):  
Sexual Dysfunction ◽  
Adverse Events ◽  
Sexual Function ◽  
Randomized Clinical Trials ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Control Group ◽  
Placebo Control ◽  
Significant Difference

Objectives: An increase in life expectancy results in the aging population growth. This study was designed to evaluate the efficacy and adverse events of ginseng that could be used as a herbal medicine in women with sexual dysfunction. Materials and Methods: The authors of this study searched Cochrane Library, MEDLINE, Web of Science, Embase, Scopus, ProQuest, Google Scholar, and Persian databases without a time limitation until May 2018 and examined all the randomized clinical trials (RCTs) that compared the effect of different types of ginseng on sexual function of menopausal women as compared to the placebo controls. The Cochrane risk of bias tool was used to assess the methodological quality of the included studies. The heterogeneity was determined using the I2 index. In addition, standardized mean difference (SMD) was used instead of mean differences (MD) and a random effect was reported instead of fixed effect in meta-analysis. Results: The eligibility criteria were found in five RCTs. All the included studies were placebo-controlled. Two trials had a parallel design while three studies used a crossover design. Although four trials indicated that ginseng significantly improved sexual function, they didn’t report any treatment effect compared to the placebo group. Based on the results of meta-analysis obtained from five studies including 531 women, there was no statistically significant effect of ginseng on female sexual dysfunction (FSD) compared to the placebo control group (SMD: 0.26; 95% CI: -0.26 to 0.76). Nonetheless, there was a considerable heterogeneity among the studies (I2 = 81%; P < 0.0001). Moreover, all the included studies assessed adverse events, but in three of the RCTs, there was no significant difference between the placebo and ginseng groups. Conclusions: The evidence regarding ginseng as a therapeutic agent for sexual dysfunction is unjustifiable. Rigorous studies seem warranted in this respect.

scholarly journals Impact of vitamin D level at diagnosis and transplantation on the prognosis of hematological malignancy: a meta-analysis

2021 ◽  
Author(s):  
YUSUKE ITO ◽  
Akira Honda ◽  
mineo kurokawa
Keyword(s):  
Vitamin D ◽  
Hematological Malignancies ◽  
Meta Analysis ◽  
Random Effect ◽  
Progression Free Survival ◽  
Cochrane Library ◽  
Hematopoietic Stem ◽  
Vitamin D Levels ◽  
The Impact ◽  
Lower Vitamin

Vitamin D deficiency impairs prognosis in many types of cancer; however, its significance in each subtype of hematological malignancies is unclear. In addition, data on the association between pre-transplant vitamin D levels and outcomes of hematopoietic stem cell transplantation (HSCT) are inconsistent. This systematic review and meta-analysis aimed to elucidate the impact of vitamin D levels at diagnosis or pre-HSCT on the prognosis of hematological malignancies. A total of 30 articles and abstracts were extracted from PubMed, Embase, Cochrane Library databases, and conference proceedings. Fixed and random-effect models were used to analyze primary outcomes: overall survival (OS) and progression-free survival (PFS). Lower vitamin D level was significantly associated with poorer OS and PFS in myeloid (hazard ratio [HR]: 1.39, 95% confidence interval [CI] 1.06-1.82; HR: 2.03, 95%CI 1.23-3.32, respectively) and lymphoid malignancies (HR: 2.07, 95%CI 1.79-2.40; HR:1.91, 95%CI 1.61-2.25, respectively), as well as outcomes of several lymphoma subtypes individually. Furthermore, pre-transplant lower vitamin D level was associated with poorer OS in both autologous and allogeneic HSCT (HR: 1.65, 95%CI 1.04-2.61; HR: 1.50, 95%CI 1.03-2.18, respectively). Despite the relatively small number of studies evaluated, these data suggest the importance of vitamin D status in outcomes of hematological malignancies (PROSPERO registration number: CRD42020205821).

Post transplant cyclophosphamide based haplo-identical transplant versus umbilical cord blood transplant; a meta-analysis

2019 ◽  
Vol 49 (10) ◽  
pp. 924-931 ◽  
Author(s):  
Kittika Poonsombudlert ◽  
Jakrin Kewcharoen ◽  
Chattip Prueksapraopong ◽  
Nath Limpruttidham
Keyword(s):  
Umbilical Cord ◽  
Graft Versus Host Disease ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Host Disease ◽  
Graft Versus Host ◽  
Post Transplant ◽  
Cord Blood Transplant ◽  
Haplo Group

Abstract Objectives Both haplo-identical transplant (haplo) and umbilical cord transplant (UC) are valuable graft options for patients without available matched relative. Previous studies showed inconsistent outcomes comparing Post transplant Cyclophosphamide based haplo (PTCy-haplo) and UC; therefore, we attempt to compare the studies by mean of meta-analysis. Methods We searched for titles of articles in MEDLINE (PubMed), Cochrane library, EMBASE database and Google scholar that compared transplantation with PTCy-haplo versus UC. We conducted a random-effect meta-analysis of seven studies involving a total of 3434 participants and reported the pooled odd ratios (OR) of acute graft-versus-host disease (aGVHD), chronic graft-versus-host disease (cGVHD), relapse and overall survival (OS) between PTCy-haplo and UC groups. Results We found a significantly decreased risk of aGVHD and relapse in the PTCy-haplo group compared to the UC group with a pooled OR of 0.78, 95% Confidence Interval (CI) 0.67-0.92, I2=0%, and 0.74, 95% CI 0.57–0.97, I2=23.9% respectively. We also found a significantly increased rate of cGVHD and OS with a pooled OR of 1.41, 95% CI 1.02–1.95, I2=56.8%, and 1.77, 95% CI 1.1–2.87, I2=82.5%, respectively. Conclusion Our meta-analysis of clinical trials demonstrated superior outcome from PTCy-haplo group compared to the UC group in terms of decreased rate of aGVHD and relapse as well as the increased rate of OS but inferior in terms of increased cGVHD risk compared to UC transplant.

scholarly journals The analgesic evaluation of gabapentin for arthroscopy: a meta-analysis of randomized controlled trials

2020 ◽  
Author(s):  
Feiri Huang ◽  
Hifan Yang ◽  
Zhongliang Su ◽  
Xiaosheng Gao
Keyword(s):  
Randomized Controlled Trials ◽  
Pain Control ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
Pain Scores

Abstract Introduction: The efficacy of gabapentin for pain management of arthroscopy remains controversial. We conduct a systematic review and meta-analysis to explore the influence of gabapentin versus placebo on the postoperative pain intensity of arthroscopy. Methods We search PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through April 2020 for randomized controlled trials (RCTs) assessing the effect of gabapentin versus placebo on pain control of arthroscopy. This meta-analysis is performed using the random-effect model. Results Five RCTs are included in the meta-analysis. Overall, compared with control group for arthroscopy, gabapentin remarkably decreases pain scores at 24 h (Std. MD=-0.68; 95% CI=-1.15 to -0.02; P = 0.21), analgesic consumption (Std. MD=-18.24; 95% CI=-24.61 to -11.88; P < 0.00001), nausea and vomiting (OR = 0.42; 95% CI = 0.21 to 0.84; P = 0.01), but has no obvious influence on pain scores at 6 h (Std. MD=-1.30; 95% CI=-2.92 to 0.31; P = 0.11) or dizziness (OR = 1.12; 95% CI = 0.56 to 2.24; P = 0.75). Conclusions Gabapentin is effective for pain control after arthroscopy.

scholarly journals Chlorhexidine Dressings to Prevent Catheter-Related Bloodstream Infections: A Systematic Literature Review and Meta-analysis

2020 ◽  
Vol 41 (S1) ◽  
pp. s165-s166
Author(s):  
Mireia Puig-Asensio ◽  
Alexandre R. Marra ◽  
Christopher A Childs ◽  
Eli N. Perencevich ◽  
Marin L. Schweizer
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Intervention Group ◽  
Experimental Studies ◽  
Bloodstream Infections ◽  
Cochrane Library ◽  
Control Group ◽  
Quasi Experimental ◽  
Pediatric Populations

Background: Catheter-related bloodstream infections (CRBSIs) are associated with significant morbidity and mortality. We aimed to determine the effectiveness of chlorhexidine (CHG) dressings in preventing incident CRBSI in different settings and types of catheters. Methods: We searched PubMed, Cochrane Library, CINAHL, Embase, and ClinicalTrials.gov through March 2019 for studies with the following inclusion criteria: (1) population consisted of patients requiring short or long-term catheters; (2) CHG dressing was used in the intervention group and a nonantimicrobial impregnated dressing was used in the control group; (3) CRBSI was reported as an outcome. Randomized controlled trials (RCTs) and quasi-experimental studies were included. We used a random-effect models to obtain pooled OR estimates. Heterogeneity was evaluated with I 2 test and the Cochran Q statistic. Results: The review included 21 studies (17 RCTs). The use of CHG dressings was associated with a lower incidence of CRBSI (pooled RR, 0.63; 95% CI, 0.53–0.76). There was no evidence of publication bias. In stratified analyses, CHG dressing reduced CRBSI in ICU adult patients (9 studies, pRR, 0.52; 95% CI, 0.38–0.72) and adults with oncohematological disease (3 studies, pRR, 0.53; 95% CI, 0.35–0.81) but not in neonates and pediatric populations (6 studies, pRR, 0.90; 95% CI, 0.57–1.40). When stratified by type of catheter, CHG dressing remained protective against CRBSI in short-term venous catheters (11 studies, pRR, 0.65; 95% CI, 0.48–0.88) but not in long-term catheters (3 studies, pRR, 0.76:; 95% CI, 0.19–3.06). Other subgroup analyses are shown in Table 1. Conclusions: CHG dressings reduce the incidence of CRBSI, particularly in adult ICU patients and adults with an onco-hematological disease. Future studies need to evaluate the benefit of CHG in non-ICU settings, in neonates and pediatric populations, and in long-term catheters.Funding: NoneDisclosures: None

scholarly journals Effectiveness of blended learning in pharmacy education: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0252461
Author(s):  
Athira Balakrishnan ◽  
Sandra Puthean ◽  
Gautam Satheesh ◽  
Unnikrishnan M. K. ◽  
Muhammed Rashid ◽  
...  
Keyword(s):  
Systematic Review ◽  
Blended Learning ◽  
Effect Size ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Pharmacy Education ◽  
Cochrane Library ◽  
Control Group ◽  
Effect Model

Background & objective Though blended learning (BL), is widely adopted in higher education, evaluating effectiveness of BL is difficult because the components of BL can be extremely heterogeneous. Purpose of this study was to evaluate the effectiveness of BL in improving knowledge and skill in pharmacy education. Methods PubMed/MEDLINE, Scopus and the Cochrane Library were searched to identify published literature. The retrieved studies from databases were screened for its title and abstracts followed by the full-text in accordance with the pre-defined inclusion and exclusion criteria. Methodological quality was appraised by modified Ottawa scale. Random effect model used for statistical modelling. Key findings A total of 26 studies were included for systematic review. Out of which 20 studies with 4525 participants for meta-analysis which employed traditional teaching in control group. Results showed a statistically significant positive effect size on knowledge (standardized mean difference [SMD]: 1.35, 95% confidence interval [CI]: 0.91 to 1.78, p<0.00001) and skill (SMD: 0.68; 95% CI: 0.19 to 1.16; p = 0.006) using a random effect model. Subgroup analysis of cohort studies showed, studies from developed countries had a larger effect size (SMD: 1.54, 95% CI: 1.01 to 2.06), than studies from developing countries(SMD: 0.44, 95% CI: 0.23 to 0.65, studies with MCQ pattern as outcome assessment had larger effect size (SMD: 2.81, 95% CI: 1.76 to 3.85) than non-MCQs (SMD 0.53, 95% CI 0.33 to 0.74), and BL with case studies (SMD 2.72, 95% CI 1.86–3.59) showed better effect size than non-case-based studies (SMD: 0.22, CI: 0.02 to 0.41). Conclusion BL is associated with better academic performance and achievement than didactic teaching in pharmacy education.

scholarly journals Effect of Dexmedetomidine For Thoracoscopic Surgery: A Meta-analysis of Randomized Controlled Trials

2021 ◽  
Author(s):  
Chengjun Song ◽  
Quan Lu
Keyword(s):  
Randomized Controlled Trials ◽  
Thoracoscopic Surgery ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Cochrane Library ◽  
Control Group ◽  
Controlled Trials ◽  
Randomized Controlled ◽  
The Impact

Abstract Introduction: The efficacy of dexmedetomidine for thoracoscopic surgery remains controversial. We conduct a systematic review and meta-analysis to explore the impact of dexmedetomidine for thoracoscopic surgery.Methods: We have searched PubMed, EMbase, Web of science, EBSCO, and Cochrane library databases through September 2020 for randomized controlled trials (RCTs) assessing the effect of dexmedetomidine on thoracoscopic surgery. This meta-analysis is performed using the random-effect model.Results: Six RCTs involving 510 patients are included in the meta-analysis. Overall, compared with control group for thoracoscopic surgery, dexmedetomidine results in significantly reduced pain scores (SMD=-1.50; 95% CI=-2.63 to -0.37; P=0.009), anesthetic consumption (SMD=-3.91; 95% CI=-6.76 to -1.05; P=0.007), mean heart rate (SMD=-0.41; 95% CI=-0.65 to -0.18; P=0.0007), and the number of ICU stay (RR=0.39; 95% CI=0.19 to 0.80; P=0.01), but showed no obvious effect on mean blood pressure (SMD=-0.07; 95% CI=-0.45 to 0.31; P=0.72) or hospital stay (SMD=-0.61; 95% CI=-1.30 to 0.08; P=0.08). Conclusions: Dexmedetomidine supplementation can substantially improve the analgesic efficacy for thoracoscopic surgery.

scholarly journals Vitamin E for the Prevention of Chemotherapy-Induced Peripheral Neuropathy: A meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Jie Chen ◽  
Haili Shan ◽  
Wenjun Yang ◽  
Jiali Zhang ◽  
Haibin Dai ◽  
...  
Keyword(s):  
Vitamin E ◽  
Peripheral Neuropathy ◽  
Meta Analysis ◽  
Random Effect ◽  
Cochrane Library ◽  
Control Group ◽  
Double Blind ◽  
Standard Mean Difference ◽  
Significant Difference ◽  
Prophylactic Use

Background: Vitamin E has been increasingly used to prevent chemotherapy-induced peripheral neuropathy (CIPN) in recent years. However, it is still unclear whether vitamin E can effectively prevent CIPN.Methods: We searched all clinical studies in the Embase, Cochrane Library, Clinicaltrials.gov, and PubMed databases from inception to December 2020. We performed a meta-analysis of 9 randomized controlled trials (RCTs) with 486 patients that compared the vitamin E group with the control group. Outcomes of the study were incidence of all-grade CIPN, incidence of severe CIPN, and the total neuropathy scores (TNS). Random effect models were used to make the meta-analysis results more cautious.Results: Notably, vitamin E significantly reduced the incidence of all-grade CIPN (overall risk ratio (RR) = 0.55, 95% CI: 0.36, 0.85, I2 = 77.3%, p = 0.007), and TNS (overall standard mean difference (SMD) = −0.64, 95% CI: −1.03, −0.25, I2 = 42.7%, p = 0.001). However, the results of the subgroup analysis, which included only double-blind RCTs, suggested that vitamin E did not significantly reduce the incidence of all-grade CIPN (overall RR = 0.52, 95% CI: 0.07, 4.06, I2 = 77.5%, p = 0.531). Moreover, there was no significant difference in the incidence of severe CIPN between these two arms (p = 0.440).Conclusion: The results of our meta-analysis suggests that vitamin E has a beneficial effect on the incidence and symptoms of CIPN. However, routine prophylactic use of vitamin E is still not recommended. Moreover, more high-quality double-blind RCTs are needed to further validate the effects of vitamin E in prevention of CIPN.

Sign in / Sign up

Export Citation Format

Share Document