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.
Objective: Total Body Irradiation (TBI) has been one of the standard conditioning regimens since the early development of allogeneic hematopoietic stem cell transplant (HSCT). Some studies have suggested a correlation between the use of TBI and the development of acute and chronic graft-versus-host disease (aGVHD and cGVHD) but there is currently no meta-analysis to confirm the association. Therefore, we conducted a meta-analysis to evaluate the association between TBI and GVHD. Method: We performed a comprehensive literature search in MEDLINE, Cochrane Library and EMBASE database from inception to February 2019 for studies that evaluated the association between TBI and aGVHD or cGVHD. We calculated pooled odd ratios (OR) with 95% confidence interval (CI) and I2 statistic using the random-effects model (Odd Ratio) of aGVHD and cGVHD in the TBI group versus the non-TBI group. Result: Thirteen studies were included involving a total of 19,303 participants (TBI=10,222, non-TBI 9,081).There was a significant association between TBI use and development of aGVHD (pooled OR 1.32, 95% CI 1.09-1.60, I2=76.7 %) and cGVHD (pooled OR 1.32, 95% CI 1.12-1.54, I2=46.2%) Conclusion: The results of our meta-analysis suggested that the use of TBI is significantly associated with aGVHD and cGVHD in the setting of allogeneic hematopoietic stem cell transplant. Citation Format: Kittika Poonsombudlert, Chattip Prueksapraopong, Jakrin Kewcharoen, Nath Limpruttidham. Total body irradiation and graft-versus-host disease: A meta-analysis [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 6006.
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