Open AccessThe Efficacy of Palifermin on Oral Mucositis and acute GVHD after Hematopoietic Stem Cell Transplantation in Hematologic Malignancy Patients: A Systematic Review and Meta-analysis study
Author(s) -
Mehrdad Payandeh,
Masoud Sadeghi,
Mazaher Ramezani,
Hamid Reza Mozaffari
Publication year - 2017
Publication title -
biomedical research and therapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.135
H-Index - 1
ISSN - 2198-4093
DOI - 10.15419/bmrat.v4i10.373
Subject(s) - mucositis , medicine , odds ratio , meta analysis , cochrane library , hematopoietic stem cell transplantation , confidence interval , gastroenterology , transplantation , publication bias , chemotherapy
Oral mucositis (OM) is one of the most common side effects after hematopoietic stem cell transplantation (HSCT) and palifermin is used for prophylactic use to prevent OM. We conducted a meta-analysis study that evaluates the efficacy of palifermin on OM after HSCT in hematologic malignancy patients. Databases of PubMed/Medline, Web of Science and Cochrane Library for English-language publications were searched for finding the relevant studies. The RevMan 5.3 software with random-effects models (odds ratio (ORs) and 95% confidence intervals (CIs)) was used for to estimate of the efficacy of palifermin in palifermin group compared with control group. Begg's and Egger's tests were used for assessment of bias between the studies. Ten studies were included in the meta-analysis study. The results of the meta-analyses showed that there were significant differences in OM (grade 1-4) [odds ratio (OR) = 0.17; 95%CI= 0.10,0.29; p <0.00001], OM (grade 2-4) [OR= 0.11; 95%CI= 0.05,0.24; p <0.00001], OM (grade 3-4) [OR= 0.22; 95%CI= 0.15,0.33; p <0.00001], after auto-HSCT for OM (grade 1-4) [OR= 0.13; 95%CI= 0.04, 0.35; p <0.0001], OM (grade 2-4) [OR= 0.03; 95%CI= 0.00, 0.21; p =0.0006] or OM (grade 3-4) [OR= 0.25; 95%CI= 0.13, 0.48; p <0.0001], after allo-HSCT for OM (grade 1-4) [OR= 0.23; 95%CI= 0.11, 0.51; p =0.0002], OM (grade 2-4) [OR= 0.14; 95%CI= 0.03, 0.74; p =0.012] or OM (grade 3-4) [OR= 0.19; 95%CI= 0.08, 0.46; p =0.0002] and fever [OR=0.51; 95%CI=0.29, 0.87; p = 0.01], but there were no significant differences in acute graft versus host disease (aGVHD) grades, infection and blood stream infection between two groups. The meta-analysis showed that palifermin was associated with reductions in the incidence and severity of OM and also was effective and safe on OM after allo- or auto-HSCT, but did not seem to effect on the incidence and severity of aGVHD.
Peer Review Details
Peer review method: Single-Blind (Peer-reviewers: 02) Peer-review policy
Plagiarism software screening?: Yes
Date of Original Submission: 01 September 2017
Date accepted: 02 October 2017
Peer reviewers approved by: Dr. Lili Hami
Editor who approved publication: Dr. Phuc Van Pham