Allogenic Lymphocyte Immunotherapy for Unexplained Recurrent Spontaneous Abortion: A Meta-Analysis.
Allogenic lymphocyte immunotherapy (LIT) as a treatment for unexplained recurrent spontaneous abortion (URSA) is still controversial due to the lack of enough controls to evaluate its effectiveness. Eighteen randomized, placebo-controlled trials with LIT for URSA were included in the meta-analysis. Live birth rates for each group were extracted, and the overall odds ratio (OR) for LIT was calculated. The success rate of treatment group was significantly higher (OR 3.74, 95% CI 3.07 ~ 4.57). LIT performed before and during pregnancy had dramatically improved the live birth rate in women with URSA (OR 4.67, 95% CI 3.70 ~ 5.90). The overall OR was 5.25 (95% CI 4.16 ~ 6.64), which supports a low dose of lymphocytes for treating URSA. Our results indicate that LIT provides a significantly beneficial effect over placebo for URSA. LIT given before and during pregnancy is superior to LIT given only before pregnancy, and the lower doses per treatment (less than 100 × 106lymphocytes or 100 mL peripheral blood) achieved a better outcome.
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Zhilan
Z
Liu
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Haijing
H
Xu
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Xiaomin
X
Kang
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Tongfei
T
Wang
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Liying
L
He
Department of Obstetrics and Gynecology, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Aimin
A
Zhao
D000026:Abortion, Habitual / Q000276:immunology / Q000473:pathology / Q000628:therapy*; D001723:Birth Rate / Q000639:trends; D005260:Female; D006801:Humans; D007167:Immunotherapy / Q000379:methods*; D017710:Lymphocyte Transfusion / Q000379:methods*; D008214:Lymphocytes / Q000166:cytology / Q000276:immunology*; D016017:Odds Ratio; D011247:Pregnancy; D016032:Randomized Controlled Trials as Topic; D013997:Time Factors; D014184:Transplantation, Homologous; D016896:Treatment Outcome
Allogenic lymphocyte immunotherapy; effectiveness; meta-analysis; timing of treatment; unexplained recurrent spontaneous abortion