Post transplant cyclophosphamide based haplo-identical transplant versus umbilical cord blood transplant; a meta-analysis

Kittika Poonsombudlert; Jakrin Kewcharoen; Chattip Prueksapraopong; Nath Limpruttidham

doi:10.1093/jjco/hyz099

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Post transplant cyclophosphamide based haplo-identical transplant versus umbilical cord blood transplant; a meta-analysis

Journal article

Open access

Peer reviewed

Post transplant cyclophosphamide based haplo-identical transplant versus umbilical cord blood transplant; a meta-analysis

Kittika Poonsombudlert, Jakrin Kewcharoen, Chattip Prueksapraopong and Nath Limpruttidham

Japanese journal of clinical oncology, Vol.49(10), pp.924-931

10/01/2019

DOI: 10.1093/jjco/hyz099

PMID: 31265729

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Abstract

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. 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. 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. 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.

Adult

Cord Blood Stem Cell Transplantation

Cyclophosphamide - therapeutic use

Female

Hematopoietic Stem Cell Transplantation

Humans

Male

Middle Aged

Transplantation, Haploidentical

Details

Title: Subtitle: Post transplant cyclophosphamide based haplo-identical transplant versus umbilical cord blood transplant; a meta-analysis
Creators: Kittika Poonsombudlert - University of Hawaii System
Jakrin Kewcharoen - University of Hawaii System
Chattip Prueksapraopong - Vajira Hospital
Nath Limpruttidham - University of Hawaii System
Resource Type: Journal article
Publication Details: Japanese journal of clinical oncology, Vol.49(10), pp.924-931
DOI: 10.1093/jjco/hyz099
PMID: 31265729
NLM abbreviation: Jpn J Clin Oncol
ISSN: 0368-2811
eISSN: 1465-3621
Language: English
Date published: 10/01/2019
Academic Unit: Internal Medicine
Record Identifier: 9984691517702771

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