Objective There are conflicting reports regarding the relative risk of acute and chronic graft-vs.-host disease (GVHD) after peripheral blood stem cell transplantation (PBSCT) compared to bone marrow transplantation (BMT). We performed a meta-analysis of the literature to determine the relative risk of acute and chronic GVHD in patienls after PBSCT or BMT from HLA-matched siblings. Data Collection A MEDLINE search generated 41 articles that were reviewed in detail. 15 studies (5 randomized controlled trials (1 in press) and 10 cohort studies) were included in this study. 2 articles contained no data on chronic GVHD. Data was extracted by two pairs of reviewers and was analyzed using STATA. Results Using a random effects model, the pooled relative risk for acute GVHD after PBSCT was 1.13 (95%CI 1.01-1.26) when compared to BMT. The pooled relative risk for chronic GVHD after PBSCT was 1.48 (95%CI 1.21-1.81) when compared to BMT. The relative risk for chronic GVHD was significant when only randomized trials (RR = 1.36 (95%CI 1.07-1.73)) or cohort trials (RR = 1.55 (95%CI 1.18-2.03)) were examined. There was little heterogeneity in this robust model and no publication bias was detected. Meta-regression demonstrated a dominant effect of the T cells transfused with the transplant and the stem cell source became insignificant. Conclusions Both acute and chronic GVHD are more common after PBSCT than BMT. The magnitude of the transfused T cell load may explain these differences.
|Original language||English (US)|
|Issue number||11 PART I|
|State||Published - Dec 1 2000|
ASJC Scopus subject areas
- Cell Biology