Risk factors for ocular graft-versus-host disease: A systematic review and meta-analysis

AIM Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is an important treatment for blood disease, and ocular graft-versus-host disease (oGVHD) is a common complication that significantly affects the quality of life of patients. Currently, the risk factors for oGVHD are still controversial.Methods To provide a scientific foundation for the prevention of oGVHD in patients undergoing allo-HSCT, studies on the factors influencing the development of oGVHD were searched in PubMed, Embase, Web of Science, Sino Med, the Cochrane Library, CIKI, the Wanfang Database, and the VIP Database from database construction to May 2024.Results Seventeen studies included 4,501 patients who received allo-HSCT, of which 1,526 were diagnosed with oGVHD, involving 22 factors. The overall prevalence of oGVHD was 37.8%.[95% CI (0.294, 0.463)].The prevalence of oGVHD based on the diagnostic criteria recommended by the National Institutes of Health was 46.7% [95% CI (0.390, 0.545)], that of the International Chronic oGVHD Group was 33.7% [95% CI (0.167, 0.506)], and that of self-defined diagnostic criteria was 32.0% [95% CI (0.184, 0.457)]. According to the meta-analysis, elderly patients [OR=1.10, 95% CI (1.00, 1.20)], female donors [OR=1.48, 95% CI (1.20, 1.83)], matched-relative donors (MRD) [OR=1.50, 95% CI (1.22, 1.83)], peripheral hematopoietic stem cells (PBSCs) [OR=1.81, 95% CI (1.38, 2.39)], acute graft-versus-host disease (aGVHD) [OR=1.74, 95% CI (1.29, 2.35)], chronic graft-versus-host disease (cGVHD) [OR=3.04, 95% CI (1.82, 5.08)], oral [OR=13.83, 95% CI (5.09, 37.56)] and skin graft-versus-host disease (GVHD) [OR=5.55, 95% CI (2.41,12.79)] were risk factors for the development of oGVHD (P < 0.0 5).Conclusion According to our systematic review and meta-analysis, the factors listed above are associated with oGVHD and can serve as early warning signs for clinicians in identifying high-risk populations eligible for early intervention and treatment.