Evidence map›Paper›PMID 18997826›Full record

SynthesisBone marrow transplantation2009

Prophylaxis regimens for GVHD: systematic review and meta-analysis.

R Ram, A Gafter-Gvili, M Yeshurun, M Paul, P Raanani, O Shpilberg

Registry-linked trialAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Bone marrow transplantation, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07724873 (A Phase I/II Trial to Assess Safety and Activity of Standardized Withaferin A as GvHD Prophylaxis in Patients Undergoing Matched Related Donor Hematopoietic Stem Cell Transplant), which is not on this map. Cited by 33 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
33citing papers in PubMed, 5 pooled it
3.9field-weighted citation impact, top 7% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT07724873 phase1 / phase2recruitingnot on this mapstarted 2025, after this paper: background citation

A Phase I/II Trial to Assess Safety and Activity of Standardized Withaferin A as GvHD Prophylaxis in Patients Undergoing Matched Related Donor Hematopoietic Stem Cell Transplant

TypeinterventionalSponsorTata Memorial CentreRan2025 to 2029Enrolled54ConditionsHematopoietic Stem Cell Transplant (HSCT), GVHD - Graft-Versus-Host Disease, Hematological MalignancyArmsSWA (standardized root extract of Withania somnifera)
3 · Its place in the literature

Who cites it

33 citing papers in PubMed, 5 syntheses or guidelines pooled it, 87 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Trial
  7. FDA Approval Summary: Abatacept for the Prophylaxis of Acute GVHD.Clinical cancer research : an official journal of the American Association for Cancer Research · 2025
    Trial
  8. Trial
  9. Trial
  10. Graft-versus-host disease treatment: predictors of survival.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2010
    Trial
  11. Review
  12. Article
  13. Review
  14. Article
  15. Article
  16. Review
  17. Prevention and Treatment of Acute Graft-versus-Host Disease in Children, Adolescents, and Young Adults.Biology of blood and marrow transplantation : journal of the American Society for Blood and Marrow Transplantation · 2020
    Review
  18. Review
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

6 authors at 1 institution in 1 country.

R RamInstitute of Hematology, Davidoff Center Rabin Medical Center, Beilinson Hospital, Petah-Tiqva, Israel.
A Gafter-Gvili
M Yeshurun
M Paul
P Raanani
O Shpilberg
Rabin Medical Center · IL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Opinions are divided regarding the best prophylactic regimen for GVHD. The aim of this study was to evaluate potential survival benefit of different prophylactic regimens for acute GVHD (aGVHD). We conducted a systematic review and meta-analysis of randomized controlled trials (RCTs) including patients undergoing Allo-SCT. We included trials that assessed the addition of MTX, compared CsA and tacrolimus and evaluated the addition of steroids. Outcomes assessed were all-cause mortality (ACM) at the longest follow-up, aGVHD, chronic GVHD, TRM, relapse rate and regimen-specific adverse events. Relative risks (RRs) with 95% confidence intervals (CIs) were estimated and pooled. The regimen of MTX-CsA vs CsA alone (four trials) yielded no statistically significant difference in ACM (RR=0.84 (0.61-1.14)), but a significant decrease in aGVHD (RR=0.52 (0.39-0.7)). There was no difference in ACM for the comparison of MTX-CsA and MTX-tacrolimus (three trials); however, MTX-tacrolimus was superior to MTX-CsA in the reduction of aGVHD (RR=0.62 (0.52-0.75)) and severe aGVHD (RR=0.67 (0.47-0.95)). The addition of steroids did not affect the outcomes (four trials). We conclude that MTX-CsA and MTX-tacrolimus are both acceptable alternatives for GVHD prophylaxis, although MTX-tacrolimus may be superior in terms of aGVHD reduction.

Indexed as

AdolescentAdultChildChild, PreschoolClinical Trials as TopicGraft vs Host DiseaseHematologic DiseasesHumansImmunosuppressive AgentsMethotrexateMiddle AgedRandomized Controlled Trials as TopicRecurrenceRiskTacrolimusTreatment OutcomeImmunosuppressive AgentsMethotrexateTacrolimus

Identifiers

PMID18997826
OpenAlexW2000949817

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.