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Haploidentical stem cell transplantation vs matched unrelated donor transplantation in adults with hematologic malignancies: a systematic review and meta-analysis.
Hematology. 2020 Dec; 25(1):356-365.H

Abstract

OBJECTIVES

Haploidentical hematopoietic stem cell transplantation (Haplo-SCT) and matched unrelated donor transplantation (MUD-SCT) are two important options when a matched sibling donor (MSD) is unavailable. Several studies comparing Haplo-SCT and MUD-SCT have reported inconsistent clinical outcomes. Therefore, it is necessary to synthesize the existing evidence regarding outcomes of stem cell transplantations comparing Haplo-SCT with MUD-SCT.

METHODS

We searched for titles of articles in MEDLINE (PubMed), Cochrane library, EMBASE database that compared transplantation with Haplo-SCT versus MUD-SCT. To compare clinical outcomes between Haplo-SCT and MUD-SCT, we performed a meta-analysis of 17 studies and reported the pooled odd ratios (OR) of 6 endpoints including overall survival (OS), progression free survival (PFS), non-relapse mortality (NRM), relapse rate (RR), acute graft-versus-host disease (aGVHD) and chronic graft- versus-host disease (cGVHD).

RESULTS

We found that Haplo-SCT was associated with a comparable OS (pooled OR of 0.99, 95% Confidence Interval (CI) 0.86-1.14), PFS (OR 1.00, 95% CI 0.88-1.15), NRM (OR 0.83, 95% CI 0.65-1.04) and RR (OR 1.08, 95% CI 0.95-1.22) compared to MUD-SCT. We also found a significantly decreased risk of aGVHD (OR 0.74, 95% CI 0.62-0.88) and cGVHD (OR 0.50, 95% CI 0.38-0.66) in Haplo-SCT group.

CONCLUSION

Results of this meta-analysis demonstrates that Haplo-SCT achieves comparable clinical outcomes compared to MUD-SCT in terms of OS, PFS, TRM and RR, but is better than MUD-SCT in terms of decreased aGVHD and cGVHD risk. Haplo-SCT is a valid option for patient needing urgent transplantation.

Authors+Show Affiliations

Department of Hematology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan Road, Nanjing 210011, People's Republic of China.Department of Hematology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan Road, Nanjing 210011, People's Republic of China.Department of Hematology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan Road, Nanjing 210011, People's Republic of China.Department of Hematology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan Road, Nanjing 210011, People's Republic of China.Department of Hematology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan Road, Nanjing 210011, People's Republic of China.Department of Hematology, Second Affiliated Hospital of Nanjing Medical University, 121# Jiangjiayuan Road, Nanjing 210011, People's Republic of China.

Pub Type(s)

Comparative Study
Journal Article
Systematic Review
Video-Audio Media

Language

eng

PubMed ID

33054609

Citation

Ma, Liyuan, et al. "Haploidentical Stem Cell Transplantation Vs Matched Unrelated Donor Transplantation in Adults With Hematologic Malignancies: a Systematic Review and Meta-analysis." Hematology (Amsterdam, Netherlands), vol. 25, no. 1, 2020, pp. 356-365.
Ma L, Han X, Jiang S, et al. Haploidentical stem cell transplantation vs matched unrelated donor transplantation in adults with hematologic malignancies: a systematic review and meta-analysis. Hematology. 2020;25(1):356-365.
Ma, L., Han, X., Jiang, S., Meng, Q., Zhang, L., & Bao, H. (2020). Haploidentical stem cell transplantation vs matched unrelated donor transplantation in adults with hematologic malignancies: a systematic review and meta-analysis. Hematology (Amsterdam, Netherlands), 25(1), 356-365. https://doi.org/10.1080/16078454.2020.1831292
Ma L, et al. Haploidentical Stem Cell Transplantation Vs Matched Unrelated Donor Transplantation in Adults With Hematologic Malignancies: a Systematic Review and Meta-analysis. Hematology. 2020;25(1):356-365. PubMed PMID: 33054609.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Haploidentical stem cell transplantation vs matched unrelated donor transplantation in adults with hematologic malignancies: a systematic review and meta-analysis. AU - Ma,Liyuan, AU - Han,Xue, AU - Jiang,Suyu, AU - Meng,Qingqi, AU - Zhang,Liubo, AU - Bao,Hongyu, PY - 2020/10/15/entrez PY - 2020/10/16/pubmed PY - 2021/2/5/medline KW - Haploidentical hematopoietic stem cell transplantation KW - acute leukemia KW - allogeneic hematopoietic stem cell transplantation KW - hematologic malignancies KW - lymphoma KW - matched related donor transplantation KW - matched unrelated donor transplantation KW - meta-analysis SP - 356 EP - 365 JF - Hematology (Amsterdam, Netherlands) JO - Hematology VL - 25 IS - 1 N2 - OBJECTIVES: Haploidentical hematopoietic stem cell transplantation (Haplo-SCT) and matched unrelated donor transplantation (MUD-SCT) are two important options when a matched sibling donor (MSD) is unavailable. Several studies comparing Haplo-SCT and MUD-SCT have reported inconsistent clinical outcomes. Therefore, it is necessary to synthesize the existing evidence regarding outcomes of stem cell transplantations comparing Haplo-SCT with MUD-SCT. METHODS: We searched for titles of articles in MEDLINE (PubMed), Cochrane library, EMBASE database that compared transplantation with Haplo-SCT versus MUD-SCT. To compare clinical outcomes between Haplo-SCT and MUD-SCT, we performed a meta-analysis of 17 studies and reported the pooled odd ratios (OR) of 6 endpoints including overall survival (OS), progression free survival (PFS), non-relapse mortality (NRM), relapse rate (RR), acute graft-versus-host disease (aGVHD) and chronic graft- versus-host disease (cGVHD). RESULTS: We found that Haplo-SCT was associated with a comparable OS (pooled OR of 0.99, 95% Confidence Interval (CI) 0.86-1.14), PFS (OR 1.00, 95% CI 0.88-1.15), NRM (OR 0.83, 95% CI 0.65-1.04) and RR (OR 1.08, 95% CI 0.95-1.22) compared to MUD-SCT. We also found a significantly decreased risk of aGVHD (OR 0.74, 95% CI 0.62-0.88) and cGVHD (OR 0.50, 95% CI 0.38-0.66) in Haplo-SCT group. CONCLUSION: Results of this meta-analysis demonstrates that Haplo-SCT achieves comparable clinical outcomes compared to MUD-SCT in terms of OS, PFS, TRM and RR, but is better than MUD-SCT in terms of decreased aGVHD and cGVHD risk. Haplo-SCT is a valid option for patient needing urgent transplantation. SN - 1607-8454 UR - https://www.unboundmedicine.com/medline/citation/33054609/Haploidentical_stem_cell_transplantation_vs_matched_unrelated_donor_transplantation_in_adults_with_hematologic_malignancies:_a_systematic_review_and_meta_analysis_ L2 - https://www.tandfonline.com/doi/full/10.1080/16078454.2020.1831292 DB - PRIME DP - Unbound Medicine ER -