Background: Mesenchymal stromal cells (MSCs) are an emerging prophylaxis option for graft-versus-host disease (GVHD) in haplo-identical hematopoietic stem cell transplantation (haplo-HSCT) recipients with severe aplastic anemia (SAA), but studies have reported inconsistent results. This systematic review and meta-analysis evaluates the efficacy of MSCs as prophylaxis for GVHD in SAA patients with haplo-HSCT. Methods: Studies were retrieved from PubMed, EMBASE, Cochrane, Web of Science and http://clinicaltrials.gov from establishment to February 2020. Twenty-nine single-arm studies (n = 1456) were included, eight (n = 241) studies combined with MSCs and eleven (n = 1215) reports without MSCs in haplo-HSCT for SAA patients. The primary outcomes were the incidences of GVHD. Other outcomes included 2-year overall survival (OS) and the prevalence of cytomegalovirus viremia (CMV). Odds ratios (ORs) were calculated to compare the results pooled through random or fixed effects models. Results: Between MSCs and no MSCs groups, no significant differences were found in the pooled incidences of acute GVHD (56.0%, 95%CI: 48.6%-63.5% vs. 47.2%, 95%CI: 29.0%-65.4%; OR 1.43, 95%CI: 0.91-2.25; p = 0.123), grade II-IV acute GVHD (29.8%, 95%CI: 24.1%-35.5% vs. 30.6%, 95%CI: 26.6%-34.6%; OR 0.97, 95%CI: 0.70-1.32; p = 0.889), chronic GVHD (25.4%, 95%CI: 19.8%-31.0% vs. 30.0%, 95%CI, 23.3%-36.6%; OR 0.79, 95%CI 0.56-1.11; p = 0.187). Furtherly, there was no obvious differences in 2-year OS (OR 0.98, 95%CI 0.60-1.61; p = 1.000) and prevalence of CMV (OR 0.61, 95%CI 0.40-1.92; p = 0.018).Conclusions: Our meta-analysis indicates that the prophylactic use of MSCs co-transplantation is not an effective option for SAA patients undergoing haplo-HSCT. Hence, the general co-transplantation of MSCs for SAA haplo-HSCT recipients may lack of evidence-based practice.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.