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Effect of autologous hematopoietic stem cell transplantation on multiple sclerosis and neuromyelitis optica spectrum disorder: a PRISMA-compliant meta-analysis

Bone Marrow Transplantation volume 55, pages 1928–1934 (2020)Cite this article

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Abstract

We should consider both the treatment effects and adverse effects of autologous hematopoietic stem cell transplantation (AHSCT) on multiple sclerosis (MS) and neuromyelitis optica spectrum disorders (NMOSD). Articles exploring the effect and safety of AHSCT in the treatment of MS and NMOSD and published before December 2019 were identified from the following databases (PubMed, Web of Science, Medline, EMBASE, Cochrane and Google Scholar). The study used STATA 13.0 software to compute the efficacy outcomes. Finally, the meta-analysis included 27 studies (including 1626 MS and 31 NMOSD patients). Regarding the effect of AHSCT on MS, the computed PFS was 74%. Subgroup analyses showed that intermediate-intensity regimen caused PFS 73%. Low-intensity regimen resulted in PFS 85%. High-intensity regimen resulted in PFS 58%. Subgroup analyses indicated that relapsing remitting MS (RRMS), primary progressive MS (PPMS) and secondary progressive MS (SPMS) patients showed PFS 81%, 78% and 60%, respectively. Computed transplant-related mortality (TRM) in MS was 1%. Regarding effect of AHSCT on NMOSD, the computed PFS and TRM was 76% and 0%, respectively. In conclusion, the study supported that AHSCT showed long-term effect on MS and NMOSD patients with a high safety. Low- and intermediate-intensity regimens and RRMS patients showed optimal benefit from AHSCT.

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Fig. 1
Fig. 2: Forest plots regarding the effect of AHSCT on MS.
Fig. 3: Forest plots regarding the TRM in MS.
Fig. 4: Forest plots regarding the effect of AHSCT on NMOSD.
Fig. 5: Forest plots regarding the TRM in NMOSD.

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Authors and Affiliations

  1. Academy of Military Medical Sciences, Academy of Military Sciences, Beijing, 100071, China

    Pengcheng Zhang & Bing Liu

  2. State Key Laboratory of Experimental Hematology, Fifth Medical Center of Chinese PLA General Hospital, Beijing, 100071, China

    Pengcheng Zhang & Bing Liu

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PZ participated in research design, the writing of the paper, the performance of the research and data analysis. BL participated in research design and data analysis.

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Correspondence to Pengcheng Zhang.

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Supplementary information

Supplementary table 1. Results of meta-regression

Supplementary table 2. The results of Begg’s and Egger’s tests

Supplementary figure 1. Subgroup studies with different types of ethnicity exploring the effect of AHSCT on MS

Supplementary figure 2. Subgroup studies with different intensity regimen on MS

Supplementary figure 3. Subgroup studies exploring the effect of AHSCT on different types of MS

Supplementary figure 4. Subgroup studies with different types of ethnicity exploring TRM of AHSCT in MS

Supplementary figure 5. Subgroup studies exploring TRM of AHSCT with different intensity regimen in MS

Supplementary figure 6. Subgroup studies exploring the TRM of AHSCT in different types of MS

Supplementary figure 7. Sensitivity analyses regarding the effect of AHSCT on MS

Supplementary figure 8. Sensitivity analyses regarding the TRM of AHSCT in MS

Supplementary figure 9. Funnel plots regarding the effect of AHSCT on MS

Supplementary figure 10. Funnel plots regarding the TRM of AHSCT in MS

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Zhang, P., Liu, B. Effect of autologous hematopoietic stem cell transplantation on multiple sclerosis and neuromyelitis optica spectrum disorder: a PRISMA-compliant meta-analysis. Bone Marrow Transplant 55, 1928–1934 (2020). https://doi.org/10.1038/s41409-020-0810-z

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