| OBJECTIVE:Published randomized trials of the use of lymphocytes immunotherapy (LIT) as a treatment for recurrent spontaneous abortion (RSA) have shown conflicting results. The purpose of this study was to conduct a meta-analysis of the current evidences to evaluate the effectiveness of LIT for RSA patients who lack of blocking antibody (BA).METHODS:The relevant literatures concerning RSA patients with BA and who receiving LIT was searched and screened based on PubMed, Medline, Embase, China Biomedical Literature Database, WanFang Database, and VIP Database (from 1996-2015). Pregnancy rates for each treatment group were extracted, and the overall odds ratio (OR) and absolute treatment effect for LIT were calculated.RESULTS:After a thorough search of the literature,13 randomized, double-blind trials comparing LIT with placebo for the treatment of RSA were included in the meta-analysis. The results of the meta-analysis were as follows: the pregnancy rates are better in LIT than in the non-lymphocytes immunotherapy (NLIT) (OR=5.72,95%CI 4.42-7.40,P<0.00001). After LIT, the pregnancy rate of positive BA group was higher than negative BA group (OR=1.58,95%CI 1.36-1.82, P<0.00001). Moreover, the abortion rate in LIT group was obviously lower than NLIT group (OR=0.19,95%CI 0.14-0.24, P<0.00001). In the positive BA group, the abortion rate was low (OR=0.15, 95%CI 0.10-0.24, P<0.00001). Irrelevant to the source of lymphocytes (partner lymphocytes or healthy donor lymphocytes), LIT displayed good therapeutic effect (OR=5.09,95%CI 3.83-6.76, P<0.00001).CONCLUSION:This meta-analysis suggests that LIT may have a role in the treatment of RSA patients with negative BA, and it can improve the pregnancy rate and reduce the abortion rate, with no matter the lymphocytes comes from partner or healthy donor. However, as yet no conclusive evidence is available. |
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