The Effect of Hematopoietic Stem Cell Transplantation on Cerebral Perfusion and Oxygen Metabolism in Patients with Sickle Cell Disease

Effect of allogeneic hematopoietic stem cell transplantation on sickle cell disease‐related organ complications: A systematic review and meta‐analysis

“…After reviewing the full‐text articles, another five studies were excluded based on study design (two because of missing outcome measure, one because of limited follow‐up, one was a literature review, and one because of different patient population). Finally, 34 studies were eligible for inclusion 8,18–50 . All 34 studies were used for the qualitative synthesis, of which 17 studies were also used in the meta‐analyses comparing organ function before and after HSCT.…”

“…Twenty‐four studies were identified that investigated either the presence of (silent) cerebral infarcts, vasculopathy, or cerebral hemodynamics before and after HSCT 8,18–21,23,25–29,31,35–42,44–47 . Except for whole‐brain cerebral blood flow and peak transcranial Doppler velocity (both low “Clinical Diversity in Meta‐analyses” score 9), the reported outcome measures and patient inclusion criteria were too heterogenous to be pooled in a meta‐analysis.…”

“…Three studies investigated cerebral vasculopathy based on MRI including whole‐brain cerebral blood flow before and after HSCT, two in children and one in adult patients 26,39,47 . Whole‐brain cerebral blood flow significantly improved after HSCT (SMD −1.39, p = <.01) (Figure 2, Table S5).…”

“…Twenty-four studies were identified that investigated either the presence of (silent) cerebral infarcts, vasculopathy, or cerebral hemodynamics before and after HSCT. 8,[18][19][20][21]23,[25][26][27][28][29]31,[35][36][37][38][39][40][41][42][44][45][46][47] Except for whole-brain cerebral blood flow and peak transcranial Doppler velocity (both low "Clinical Diversity in Meta-analyses" score 9), the reported outcome measures and patient inclusion criteria were too heterogenous to be pooled in a meta-analysis. A summary of the study characteristics evaluating cerebral function parameters and cerebral damage and their main findings is presented in Tables S7 and S8.…”

“…Two of these studies compared cerebral hemodynamics and oxygen metabolism of SCD transplant recipients to a healthy control group showing a normalization of cerebral blood flow. 26,47 One study compared cerebral blood flow in transplanted SCD patients with that in SCD patients undergoing chronic transfusion therapy. While cerebral blood flow decreased significantly following HSCT, no significant improvement was observed in the chronic transfusion group.…”