Cochrane · systematic review · CD011819
Stem cell transplantation for systemic sclerosis
Bruera, S, Sidanmat, H, Molony, DA, et al. · Cochrane Database of Systematic Reviews · 2022 · Cochrane Library
MusculoskeletalAMSTAR 2: not assessed
SoF tableOnly the outcomes this review put in its Summary of Findings table are listed (the Cochrane Handbook caps them at about seven per comparison). Its other analyses are not shown here.
Questions
21
current version
GRADE rated
16
No studies
5
Included studies
NR
No studies 5 · 23.8%Ungraded 0 · 0%Very low 0 · 0%Low 6 · 28.6%Moderate 10 · 47.6%High 0 · 0%
Ungraded means an effect was reported without a GRADE rating; it is not a gap. No studies means the review found nothing to answer the question. The six categories are a display order, not a score.
Questions and results
Autologous non‐myeloablative selective HSCT compared to cyclophosphamide in systemic sclerosis
Population: people with systemic sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall mortality Autologous non‐myeloablative selective HSCT vs cyclophosphamide | RR 0.9 [0.44, 1.85] | 1 study · 156 participants | Moderate Downgraded: imprecision |
Event‐free survival Autologous non‐myeloablative selective HSCT vs cyclophosphamide | HR 0.34 [0.16, 0.74] | 1 study · 156 participants | Moderate Downgraded: imprecision |
Functional ability –HAQ‐DI Scale 0–3, with 0 representing no/mild impairment and 3 representing very severe impairment. Autologous non‐myeloablative selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 131 participants | Low Downgraded: risk of bias, imprecision |
Skin thickness – mRSS The scale is from 0 to 51 in which a higher number is worse skin thickening. Autologous non‐myeloablative selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 131 participants | Moderate Downgraded: imprecision |
Interstitial lung disease – FVC % predicted A lower percentage represents worse lung disease Autologous non‐myeloablative selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 131 participants | Moderate Downgraded: imprecision |
Pulmonary arterial hypertension Autologous non‐myeloablative selective HSCT vs cyclophosphamide | no estimate extracted | NR | No studies |
Serious adverse events Autologous non‐myeloablative selective HSCT vs cyclophosphamide | RR 1.7 [1.2, 2.3] | 1 study · 156 participants | Moderate Downgraded: imprecision |
Autologous myeloablative selective HSCT compared to cyclophosphamide in systemic sclerosis
Population: people with systemic sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall mortality Autologous myeloablative selective HSCT vs cyclophosphamide | RR 0.59 [0.24, 1.43] | 1 study · 75 participants | Moderate Downgraded: imprecision |
Event‐free survival Autologous myeloablative selective HSCT vs cyclophosphamide | HR 0.54 [0.23, 1.27] | 1 study · 75 participants | Moderate Downgraded: imprecision |
Functional ability – HAQ‐DIb Scale 0–3 with 0 representing no/mild impairment and 3 representing very severe impairment. The study incorporated a ≥ 0.4 threshold. Autologous myeloablative selective HSCT vs cyclophosphamide | RR 3.43 [1.54, 7.62] | 1 study · 75 participants | Low Downgraded: risk of bias, imprecision |
Skin thickness – mRSS Scale 0–51 in which a higher number is worse skin thickening. The study incorporated a ≥ 25% improvement threshold. Autologous myeloablative selective HSCT vs cyclophosphamide | RR 1.51 [1.06, 2.13] | 1 study · 75 participants | Moderate Downgraded: imprecision |
Interstitial lung disease – FVC (% predicted) A lower percentage represents worse lung disease. The study incorporated a ≥ 10% chance Autologous myeloablative selective HSCT vs cyclophosphamide | RR 1.63 [0.75, 3.51] | 1 study · 75 participants | Moderate Downgraded: imprecision |
Pulmonary arterial hypertension Autologous myeloablative selective HSCT vs cyclophosphamide | no estimate extracted | NR | No studies |
Serious adverse events Autologous myeloablative selective HSCT vs cyclophosphamide | RR 1.43 [0.99, 2.08] | 1 study · 71 participants | Moderate Downgraded: imprecision |
Autologous non‐myeloablative non‐selective HSCT compared to cyclophosphamide in systemic sclerosis
Population: people with systemic sclerosis
| Outcome | Effect | Evidence | Status / GRADE |
|---|---|---|---|
Overall mortality Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 19 participants | Low Downgraded: imprecision |
Event‐free survival Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | NR | No studies |
Functional ability – HAQ‐DI Scale 0–3 with 0 representing no/mild impairment and 3 representing very severe impairment. The study incorporated a ≥ 0.4 threshold Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | NR | No studies |
Skin thickness – mRSS Scale 0–51 in which a higher number is worse skin thickening Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 19 participants | Low Downgraded: imprecision |
Interstitial lung disease – FVC % predicted A lower percentage represents worse lung disease. The study incorporated a ≥ 15% chance Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 19 participants | Low Downgraded: imprecision |
Pulmonary arterial hypertension Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | NR | No studies |
Serious adverse events Autologous non‐myeloablative non‐selective HSCT vs cyclophosphamide | no estimate extracted | 1 study · 19 participants | Low Downgraded: imprecision |