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

Am J Reprod Immunol. 2016 Dec;76(6):443-453. doi: 10.1111/aji.12511. Epub 2016 Apr 22.

Abstract

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 × 106 lymphocytes or 100 mL peripheral blood) achieved a better outcome.

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

Publication types

  • Meta-Analysis

MeSH terms

  • Abortion, Habitual / immunology
  • Abortion, Habitual / pathology
  • Abortion, Habitual / therapy*
  • Birth Rate / trends
  • Female
  • Humans
  • Immunotherapy / methods*
  • Lymphocyte Transfusion / methods*
  • Lymphocytes / cytology
  • Lymphocytes / immunology*
  • Odds Ratio
  • Pregnancy
  • Randomized Controlled Trials as Topic
  • Time Factors
  • Transplantation, Homologous
  • Treatment Outcome