scholarly journals Efficacy and Safety of Mesenchymal Stem Cells Co-Infusion in Allogeneic Hematopoietic Stem Cell Transplantation: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Teng li ◽  
Chengxin Luo ◽  
Jiasi Zhang ◽  
Ling Wei ◽  
Wei Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Lower Risk ◽  
Meta Analysis ◽  
Current Evidence ◽  
Efficacy And Safety

Abstract BackgroundHematopoietic stem cell transplantation (HSCT) is a life-saving strategy for severe hematological conditions, but its efficacy and safety need further improvement. Co-infusion of mesenchymal stem cells (MSCs) may bring promise for the overall efficacy in HSCT setting. About that there are increasing studies, while the results from different trials are conflicting. A systematic review and meta-analysis are needed to appraise the real efficacy of MSCs co-infusion in HSCT. MethodsFive medical databases were searched to identify related controlled studies, which included individuals with hematological diseases receiving allogeneic HSCT (allo-HSCT), and with MSCs co-infusion as intervention arm versus no MSCs as comparison arm. Meta-analysis was performed using RevMan 5.4.ResultsUltimately, 19 trials met the inclusion criteria. MSCs co-infusion was associated with shorter time both to ANC engraftment (4RCTs: SMD -1.20, p = 0.04; 10nRCTs: SMD -0.54, p = 0.04) and PLT engraftment (4RCTs: SMD -0.60, p = 0.04; 10nRCTs: SMD -0.70, p = 0.01), lower risk of cGVHD incidence (4RCTs: RR 0.53, p = 0.01; 10nRCTs: RR 0.50, p < 0.01), and slightly positive trend towards the risk of aGVHD incidence (3RCTs: RR 0.84, p = 0.33; 9nRCTs: RR 0.74, p < 0.01) and NRM(3RCTs: OR 0.59, p = 0.34; 3nRCTs: OR 0.18, p < 0.01); didn’t affect relapse (5RCTs: RR 1.34, p = 0.34; 4nRCTs: RR 0.74, p = 0.24) and overall survival (4RCTs: HR 1.54, p = 0.18; 6nRCTs: HR 0.60, p = 0.06). Subgroup analyses revealed that, when co-transplanted with MSCs, patients younger than 18 or those received HLA-haploidentical grafts had improved engraftment (ANC and PLT）and lower risk of NRM and GVHD (acute and chronic forms) incidence. For adults or those received HLA-identical grafts, the risk of cGVHD incidence were reduced. Patients with hematologic malignancies had lower risk of developing GVHD and NRM, patients with non-malignancies showed faster engraftment.ConclusionWithout increasing the risk of mortality or relapse, MSCs co-infusion in allo-HSCT improved engraftment of platelet and neutrophil, reduced the risk of developing cGVHD. In terms of aGVHD and NRM, the effect of MSCs co-infusion was not quite significant with current evidence.

scholarly journals Evaluation of the Efficacy of Stem Cell Therapy in Ovariectomized Osteoporotic Rats Based on Micro-CT and Dual-Energy X-Ray Absorptiometry: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-18
Author(s):  
Zhencheng Xiong ◽  
Ping Yi ◽  
Jialiang Lin ◽  
Shengfeng Qiu ◽  
Li Shu ◽  
...  
Keyword(s):  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Cell Therapy ◽  
Stem Cell Transplantation ◽  
Cell Transplantation ◽  
Stem Cell Therapy ◽  
Meta Analysis ◽  
Bone Volume ◽  
Inclusion Criteria

Objective. Osteoporosis is an abnormal bone metabolism disease characterized by microstructural degeneration of bone tissue and reduction in bone mass, resulting in increased brittleness of bone tissue and susceptibility to fracture. Due to the tissue regenerative potential of stem cell transplantation, it is now used in the treatment of various disease models such as osteoporosis. The purpose of this work is to carry out a systematic review and meta-analysis of the efficacy of stem cell therapy in ovariectomized (OVX) osteoporotic rats. Methods. PubMed, Cochrane Library, ScienceDirect, Embase, CNKI, and Wanfang Databases were used to search for articles that met the inclusion criteria. Two researchers independently screened the articles that met the inclusion criteria. RevMan 5.3 and STATA 16.0 were used for data analysis. This meta-analysis was registered at INPLASY with reference number ID: INPLASY202150017. Results. Thirteen eligible studies were selected, including 405 rats. The sources of stem cells are divided into four main categories: bone marrow mesenchymal stem cells (BMSCs), adipose-derived stem cells (ADSCs), amniotic membrane mesenchymal stem cells (AM-MSCs), and human umbilical cord blood-derived mesenchymal stem cells (hUCB-MSCs). Compared with the OVX group, both stem cell transplantation groups had higher bone mineral density (BMD) (BMSCs: SMD = 2.01 , 95% CI: [1.38, 2.63], P < 0.001 , I 2 = 76.6 % ; ADSCs: SMD = 2.24 , 95% CI: [0.79, 3.69], P = 0.003 , I 2 = 86.7 % ) and bone volume/total volume (BV/TV) (hUCB-MSCs: SMD = 1.71 , 95% CI: [0.97, 2.44], P < 0.001 , I 2 = 0 % ; ADSCs: SMD = 2.16 , 95% CI: [0.27, 4.04], P = 0.025 , I 2 = 82.6 % ). In the BMSC treatment groups, the trabecular numbers (Tb.N) ( SMD = 4.28 , 95% CI: [0.91, 7.64], P = 0.013 , I 2 = 94.9 % ) were significantly higher, whereas the results for trabecular thickness (Tb.Th) ( SMD = 2.7 , 95% CI: [-0.34, 5.73], P = 0.081 , I 2 = 95.4 % ) and trabecular spacing (Tb.Sp) ( SMD = − 3.08 , 95% CI: [-6.55, 0.38], P = 0.081 , I 2 = 96.3 % ) were not statistically significant compared to those of the OVX group. The stem cell transplantation group had a low BMD, BV/TV, and Tb.N compared to the sham operation group. Conclusion. Stem cell therapy may increase bone strength, bone volume, and the number of trabeculae in OVX osteoporotic rats. The results of this meta-analysis showed the potential therapeutic effect of stem cell transplantation in OVX osteoporotic rats, bringing new therapeutic ideas and directions to the clinical treatment of osteoporosis. Due to the limited number and quality of studies related to some outcomes, more high-quality RCTs are still needed in the future to complement the existing findings.

scholarly journals Efficacy and safety of mesenchymal stem cells co-infusion in allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Teng Li ◽  
Chengxin Luo ◽  
Jiasi Zhang ◽  
Ling Wei ◽  
Wei Sun ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Mesenchymal Stem Cells ◽  
Stem Cell ◽  
Hematological Malignancies ◽  
Meta Analysis ◽  
Controlled Trials ◽  
Efficacy And Safety ◽  
Hematopoietic Stem ◽  
Randomized Controlled

Abstract 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.

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