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Hematopoietic stem cell transplantation therapy for refractory' Crohn disease: A systematic review and meta-analysis

Victor Serrano-Fernandez1,2, Juan Manuel Carmona-Torres1,3, Almudena Arroyo-Rodriguez4

  • 1Facultad de Fisioterapia y Enfermería, Universidad de Castilla-La Mancha, Toledo, Spain.

Medicine
|October 21, 2024
PubMed

Insights

Autologous hematopoietic stem cell transplantation (aHSCT) shows promise for refractory Crohn disease, effectively reducing disease activity and treating perianal fistulas. However, careful consideration of associated risks is crucial before implementation.

Area of Science:

  • Gastroenterology
  • Immunology
  • Regenerative Medicine

Background:

  • Crohn disease lacks effective treatments for all patients, impacting quality of life.
  • Refractory Crohn disease necessitates exploring novel therapeutic strategies.

Purpose of the Study:

  • To systematically review and meta-analyze the efficacy and safety of autologous hematopoietic stem cell transplantation (aHSCT) for refractory Crohn disease.
  • To assess aHSCT's impact on Crohn disease activity and perianal fistulas.

Main Methods:

  • Systematic review and meta-analysis following PRISMA guidelines.
  • Searched PubMed, Scopus, Web of Science, and ClinicalTrials databases.
  • Analyzed Crohn's Disease Activity Index (CDAI) for remission and fistula healing rates.

Main Results:

  • aHSCT significantly decreased CDAI (-217.53 ± 14.3) and improved perianal fistulas (RR 0.47, 95% CI [0.26, 0.86]).
  • Immediate aHSCT intervention was more effective than late conventional therapies.
  • Adverse events included infections, acute renal failure, and deaths.

Conclusions:

  • Systemic aHSCT is effective for Crohn disease patients unresponsive to conventional therapies.
  • aHSCT demonstrates efficacy in managing perianal fistulas associated with Crohn disease.
  • Careful risk-benefit evaluation is essential due to potential adverse effects.
Abstract

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