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

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 cells (MSCs) may show promise. A growing body research on this subject exists, while the results different trials are conflicting. systematic review meta-analysis needed to appraise real efficacy safety MSC co-transplantation in allo-HSCT. Methods Studies comparing allo-HSCT with alone were searched six medical databases from inception June 10, 2020. The primary engraftment graft-versus-host disease (aGVHD cGVHD, respectively). Other included overall survival (OS), relapse rate (RR), non-relapse mortality (NRM), immune reconstitution. Information was independently extracted by two investigators. Methodological quality assessed using Cochrane Collaboration tool. Meta-analysis performed RevMan 5.4. Results Six randomized controlled (RCTs) 13 non-randomized (nRCTs) included. resulted shorter times neutrophil (RCTs: standardized mean difference (SMD) − 1.20, p = 0.04; nRCTs: SMD 0.54, 0.04) platelet 0.60, 0.70, 0.01), a lower risk cGVHD ratio (RR) 0.53, 0.01; RR 0.50, < slightly positive trend towards reducing aGVHD NRM, without affecting OS. Subgroup analyses revealed that when MSCs co-transplanted, children adolescents, patients receiving human leukocyte antigen (HLA)-nonidentical HSCT showed improvements incidence GVHD NRM; adults who received HLA-identical had cGVHD; malignancies exhibited NRM incidence; non-malignancies experienced accelerated engraftment. Notably, reduced OS observed undergoing HSCT. Conclusion generally improved increasing or relapse. Regarding effects not quite significant. Specifically, our data support utilization young individuals HLA-nonidentical HSCT, but adult