Efficacy of hematopoietic stem cell transplantation treatment in refractory chronic inflammatory demyelinating polyradiculoneuropathy: a systematic review and meta-analysis.

Abstract

BACKGROUND AND PURPOSE:

Treatment options for chronic inflammatory demyelinating polyneuropathy (CIDP) are intravenous immunoglobulin, plasmapheresis, corticosteroids and immunosuppressive drugs. However, a substantial proportion of patients with CIDP remain refractory to treatment and develop severe functional disability. A systematic review and a meta-analysis of the efficacy of hematopoietic stem cell transplantation (HSCT) treatment in refractory CIDP patients was performed.

METHODS:

The study is based on queries in the PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science and clinicaltrials.gov databases on 4 December 2022. Articles that met our eligibility criteria were included after screening. Patients' characteristics, treatment regime and outcome measures were extracted.

RESULTS:

Eighty-nine patients in 11 studies were included. The pooled estimate of responsiveness amongst the four included studies was 87.04% (95% confidence interval 66.7%-99.5%) and the pooled estimate of freedom of all immune modulating or suppressive drugs was 80.75% (95% confidence interval 71.2%-90.2%).

CONCLUSION:

This meta-analysis and systematic review suggested that HSCT can be effective in the treatment of refractory CIDP. Whilst there are risks involved, HSCT may be a beneficial and viable therapy for refractory CIDP when carefully evaluated.

• Authors: Yongsheng Zheng, Jianian Hu, Chong Sun, Chongbo Zhao, Jie Lin
• Journal: European journal of neurology (Eur J Neurol) Vol. 30 Issue 8 Pg. 2570-2582 (08 2023) ISSN: 1468-1331 [Electronic] England
• PMID: 37170791 (Publication Type: Meta-Analysis, Systematic Review, Journal Article, Review)
• Copyright: © 2023 European Academy of Neurology.

Chemical References

• Immunoglobulins, Intravenous
• Immunosuppressive Agents
• Adrenal Cortex Hormones

Topics

• Humans
• Polyradiculoneuropathy, Chronic Inflammatory Demyelinating (diagnosis)
• Immunoglobulins, Intravenous (therapeutic use)
• Immunosuppressive Agents (therapeutic use)
• Adrenal Cortex Hormones (therapeutic use)
• Hematopoietic Stem Cell Transplantation (adverse effects)