Evidence map›Paper›PMID 40694279›Full record

SynthesisStem cell reviews and reports2025

Efficacy and Safety of Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease: An Updated Meta-Analysis of Randomized Controlled Trials.

Iftikhar Khan, Umama Rehman, Fatima Aslam, Saad Khan, Umna Bhatti, Hussain Ramzan, Fatima Naveed, Javeria Nawaz, Syeda Malaika Raza, Kiran Inam and 6 more

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Stem cell reviews and reports, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Review
  2. Article
  3. Article
  4. Review
  5. Review
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors.

Iftikhar KhanFMH College of medicine and dentistry, Lahore, Pakistan.ORCID 0009-0004-9579-011X
Umama RehmanKhyber Medical College, Peshawar, Pakistan.ORCID 0009-0001-2632-5669
Fatima AslamTucson Medical Center, Tucson, AZ, USA.ORCID 0009-0006-9015-619X
Saad KhanSaidu Medical College, Swat, Pakistan.
Umna BhattiJinnah Sindh Medical University, Karachi, Pakistan.
Hussain RamzanNishtar Medical University and Hospital, Multan, Pakistan.
Fatima NaveedRawal Institute of Health Sciences, Islamabad, Pakistan.
Javeria NawazDow University of Health Sciences, Karachi, Pakistan.ORCID 0009-0003-1949-7600
Syeda Malaika RazaJinnah Sindh Medical University, Karachi, Pakistan.
Kiran InamUniversity of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Faiza RajputDow University of Health Sciences, Karachi, Pakistan.ORCID 0009-0001-9112-2892
Syed Muhammad SeyabAllama Iqbal Medical College, Lahore, Pakistan.
Muhammad RiyyanWarren Alpert School of Medicine at Brown University, Rhode, Island.
Ayesha Imran ButtAllama Iqbal Medical College, Lahore, Pakistan.ORCID 0009-0005-4632-6238
Hira HabibAllama Iqbal Medical College, Lahore, Pakistan.ORCID 0009-0006-4013-4945
Ehsanullah AlokozayFaculty of Medicine, Kandahar University, District 10, Near the Aino Mina Residential Area, and the Durahi intersection, Kandahar, Afghanistan. hebibzaiehsanullah@gmail.com.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundSteroid-refractory acute graft-versus-host disease (SR-aGVHD) is a life-threatening complication of allogeneic hematopoietic stem cell transplantation with limited effective second-line therapies. Mesenchymal stromal cells (MSCs) have emerged as a promising therapeutic option due to their immunomodulatory properties; however, their clinical efficacy and safety remain under debate.

methodsA systematic review and meta-analysis were conducted in accordance with the PRISMA 2020 guidelines, including four randomized controlled trials (RCTs) comprising 650 patients. Primary outcomes included overall response rate (ORR), complete response (CR), and overall survival (OS). Secondary outcomes assessed organ-specific responses, adverse events (AEs), serious adverse events (SAEs), and failure-free survival.

resultsMSC therapy significantly improved overall response rate (ORR) (RR = 1.13; 95% CI: 1.04-1.23; P = 0.005) and complete response (CR) rate (RR = 1.60; 95% CI: 1.35-1.90; P < 0.00001), particularly in patients with grade III-IV acute graft-versus-host disease (aGVHD) and those with gut and skin involvement. There was no significant improvement in OS (RR = 1.05; 95% CI: 0.90-1.23; P = 0.52), AEs (RR = 1.00; P = 0.96), or SAEs (RR = 1.01; P = 0.79). MSCs showed significant benefit in reducing multi-organ aGVHD (RR = 1.25; P = 0.007), but not for liver involvement or grade II-IV disease. Heterogeneity across studies was generally low to moderate.

conclusionMSCs demonstrate significant efficacy in improving short-term clinical responses in SR-aGVHD, without increasing adverse events, particularly in cases of severe and multi-organ disease. However, they do not confer a survival benefit. Further large-scale, standardized, randomized controlled trials (RCTs) with long-term follow-up are warranted to validate these findings and inform clinical implementation. CLINICAL TRIAL NUMBER: Not applicable.

Indexed as

Graft vs Host DiseaseMesenchymal Stem CellsMesenchymal Stem Cell TransplantationSteroidsAcute DiseaseHematopoietic Stem Cell TransplantationHumansRandomized Controlled Trials as TopicTreatment OutcomeSteroidsHematopoietic stem cell transplantationImmunotherapyMesenchymal stromal cellsOverall response rateSecond-line therapySteroid-refractory acute graft-versus-host disease

Identifiers

PMID40694279

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.