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Allogenic Lymphocyte Immunotherapy for Unexplained Recurrent Spontaneous Abortion: A Meta-Analysis

Journal

AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
Volume 76, Issue 6, Pages 443-453

Publisher

WILEY
DOI: 10.1111/aji.12511

Keywords

Allogenic lymphocyte immunotherapy; effectiveness; meta-analysis; timing of treatment; unexplained recurrent spontaneous abortion

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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 similar to 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 similar to 5.90). The overall OR was 5.25 (95% CI 4.16 similar to 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 x 10(6) lymphocytes or 100 mL peripheral blood) achieved a better outcome.

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