Evidence mapPaperPMID 41383246Full record

ArticleExperimental and therapeutic medicine2026

Mammalian target of rapamycin inhibitors as the treatment for steroid-refractory acute graft-vs.-host disease after allogeneic hematopoietic stem cell transplantation: A systematic review and individual patient data meta-analysis.

Yanru Guo, Zhi Li, Yiqun Zhang, Zhijuan Pan, Jiajia Sun, Ying Zhang, Shuting Chang, Zhiping Guo

Abstract read
In one paragraph

Article in Experimental and therapeutic medicine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Yanru GuoDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.
Zhi LiSchool of Sport And Physical Education, North University of China, Taiyuan, Shanxi 030000, P.R. China.
Yiqun ZhangDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.
Zhijuan PanDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.
Jiajia SunDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.
Ying ZhangDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.
Shuting ChangDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.
Zhiping GuoDepartment of Hematology, Peking University First Hospital Taiyuan Branch (Taiyuan Central Hospital), The Ninth Clinical Medical College of Shanxi Medical University, Taiyuan, Shanxi 030009, P.R. China.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The prognosis of patients with steroid-refractory acute graft-vs.-host disease (SR-aGVHD) following allogeneic hematopoietic stem cell transplantation (allo-HSCT) remains poor. Furthermore, the recommendations for second- and third-line therapeutic approaches are controversial. The present study aimed to analyze the efficacy and safety of mammalian target of rapamycin (mTOR) inhibitors in SR-aGVHD after allo-HSCT. The present study searched the PubMed and Embase databases for relevant publications from December 2001 to September 2024. The primary endpoints were overall response rate (ORR), complete response rate (CRR), chronic GVHD, overall survival (OS) and infection-related complications at any time after mTOR inhibitor therapy. The response rate at 1 month after mTOR inhibitor therapy was also assessed. The present meta-analysis included 5 studies involving 134 patients. The ORR and CRR at any time were 65% (95% CI, 44-81%) and 46% (95% CI, 22-72%) after mTOR inhibitor-based therapy for SR-aGVHD, respectively, with 1- to 3-year OS rate ranging from 36% (95% CI, 27-46%) to 30% (95% CI, 20-42%) The ORR and CRR after a 1-month treatment with mTOR inhibitors were 57% (95% CI, 34-78%) and 58% (95% CI, 13-93%), respectively. Transplant-associated thrombotic microangiopathy (TA-TMA) and cytopenia occurred in 36% (95% CI, 22-52%) and 43% (95% CI, 18-72%) of patients with SR-aGVHD, leading to treatment interruption with mTOR inhibitors in 10% (95% CI, 5-22%) and in 6% (95% CI, 2-13%) of patients, respectively. The highest CRR (78%) was observed in steroid-refractory patients treated with mTOR inhibitors combined with IL-2R antagonists, with an mTOR inhibitor serum trough level of 7-13 ng/ml, although a minimum therapeutic level was 4 ng/ml. Prolonged therapy was more likely to be effective. In conclusion, mTOR inhibitors exhibit potent activity against SR-aGVHD. However, their use may be associated with complications such as TA-TMA and cytopenia.

Indexed as

acute graft-vs.-host diseasemammalian target of rapamycin inhibitorsmeta-analysissecond-line treatmentsteroid-refractory

Identifiers

PMID41383246
PMCPMC12690439

What Socratic holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.