The Role of Antioxidant Supplementation in Patients Undergoing Hematopoietic Stem Cell Transplantation: A Systematic Review
A partir d'une revue systématique de la littérature publiée jusqu'en janvier 2024 (20 études), cette étude analyse les effets d'une supplémentation en antioxydants chez des patients recevant une greffe de cellules souches hématopoïétiques
Background: Patients undergoing hematopoietic stem cell transplantation (HSCT) often face complications during the acute posttransplantation period. HSCT complications are linked to oxidative stress (OS) mechanisms due to accumulation of reactive oxygen species. Researchers hypothesize that antioxidant levels may modify OS immediately after HSCT.
Objective: This systematic review aimed to collect evidence on the role of antioxidant supplementation in determining the outcomes and complications of HSCT.
Study Design: A systematic search of two databases was conducted, including studies published until January 2024. Inclusion criteria involved clinical original studies focusing on adults and children undergoing HSCT who received antioxidant supplementation during and/or after HSCT.
Results: The review included 20 eligible studies, featuring antioxidants such as N-acetyl cysteine, vitamin C, zinc, selenium, vitamin E, and melatonin. Outcomes examined included immune system recovery, engraftment, oral mucositis, liver toxicity, nephrotoxicity, and acute graft-versus-host disease. The findings indicate an unclear association between antioxidant use and complications after HSCT. The certainty of evidence for these outcomes was low or very low.
Conclusions: Although the use of antioxidants in HSCT patients has been deemed safe and has even been associated with positive outcomes in some studies, the necessity for antioxidant supplementation during HSCT remains uncertain. Further large randomized controlled trials are necessary to ascertain antioxidant requirements and establish precise supplementation protocols for HSCT patients.
European Journal of Cancer Care , article en libre accès, 2025