Mesenchymal stem cells added to second-line therapy improve response and failure-free survival in steroid-refractory acute graft-versus-host disease after allogeneic hematopoietic stem cell transplantation: A meta-analys

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

• Level A · Stronger Clinical Evidence
• Level B · Emerging clinical evidence with positive signals
• Level C · Early human research exploring benefits
• Level D · Scientific groundwork from lab and animal studies
• Emerging · Emerging topic under active research

Abstract (original English)

Background Steroid-refractory acute graft-versus-host disease (aGVHD) remains a major cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (allo-HSCT), with limited effective treatment options. Mesenchymal stem cells (MSCs) have emerged as a promising therapeutic approach due to their immunomodulatory and tissue-repair properties. However, inconsistent results existed. Methods A systematic literature search was conducted in PubMed, Embase, and the Cochrane Central Register of Controlled Trials up to May 2025. Randomized controlled trials (RCTs) evaluating MSCs plus second-line therapy versus second-line therapy alone in patients with steroid-refractory aGVHD were included. Meta-analysis was performed using random-effects models to pool risk ratios (RR) or hazard ratios (HR) with 95% confidence intervals (CIs). Results Four RCTs comprising 650 patients were included. MSC administration significantly improved overall response (RR: 1.13, 95% CI: 1.03-1.23, P = 0.007) and complete response rates (RR: 1.43, 95% CI: 1.19-1.70, P Conclusions The addition of MSCs to second-line therapy significantly improves treatment response, reduces chronic GVHD incidence, and prolongs failure-free survival in patients with steroid-refractory aGVHD, with a favorable safety profile. These findings support MSC-based therapy as a promising strategy for this high-ris

Evidence level

Relatively higher-quality human studies compared with other topics in this database, e.g. multiple RCTs or systematic reviews. This does not mean it is standard or approved care.

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