Gestational and perinatal outcomes in recurrent miscarriages couples treated with lymphocyte immunotherapy

Abstract

Objective This study aims to elucidate which types of recurrent miscarriage (RM) patients experienced a livebirth after paternal lymphocyte immunotherapy (LIT) and to evaluate the perinatal outcome. Study design Retrospective analysis of a multicenter, observational study which enrolled 1096 couples with a history of two or more spontaneous miscarriages without any intercalated delivery. We conducted an intention-to-treat analysis of couples with RM treated with or without LIT regarding to gestational and perinatal outcomes. We compared groups by using the Student’s t -test or Kruskal–Wallis test, Fisher’s exac t -test and χ 2 test when appropriate. Results The success of gestation was significantly higher in the LIT group (60.1% vs. 33.1%; p < 0.001). A sub-analysis of four different immune disorder groups revealed a significantly higher success in the LIT group in all immune categories, except in patients who had autoantibodies positive. We observed no significant differences in perinatal outcomes such as gestational age at birth, preterm and extreme preterm birth, and birth weight in successful pregnancy in both groups. The success rate was significantly higher when LIT was administrated before and during pregnancy and only during pregnancy compared to only before pregnancy ( p < 0.01). Conclusions Careful laboratory test phenotyping of RM patients may identify subgroups most likely to benefit and exclude those with little likelihood of benefit, and LIT during a pregnancy may significantly improve success rates.

The Effects of LIT and MLR-Bf on Immune Biomarkers and Pregnancy Outcomes in Women With Previous Early Recurrent Miscarriage: A Retrospective Study

“…In this present study, both MLR-Bf and LIT were included to explore their independent associations with miscarriage. This is something rarely demonstrated before (31)(32)(33). With that, LIT was identified as the sole contributor to the differences in successful pregnancy rates.…”

Lymphocyte immunotherapy in recurrent miscarriage and recurrent implantation failure

“…The meta‐analysis of studies included in the two most relevant meta‐analyses (Cochrane and Liu et al) 19,33 together with the data recently published by our group 34 revealed a positive impact of LIT on the number of live births in patients with a history of RM (OR: 3.22, 95% CI 2.74–3.78, p < 0.00001) (Table 1) (Figure 1).…”

“…Gestational success was observed in 74.2% of cases when the LIT was given only before pregnancy and 78.3% when the LIT was given before and during pregnancy. Liu et al also highlighted greater effectiveness of LIT when administered before and during pregnancy (OR: 4.67, 95% CI 3.70–5.90, p < 0.00001) compared with immunization only before pregnancy (OR: 2.00, 95% CI 1.39–2.88, p = 0.0002) 34 . Other meta‐analyses that also evaluated gestational success in relation to the timing of treatment agreed that the best results were obtained with the pre‐gestational initiation of LIT and its maintenance in the first months of pregnancy 19,20 …”

“…Meta‐analysis of LIT for the treatment of RM analyzing studies included in the recent meta‐analysis of Cochrane, 19 Liu et al, 33 and data by Sarno et al 34 …”

Reply to letter to the editor: “Safety of lymphocytes immunotherapy during the COVID-19 outbreak in Wuhan, China”

“…The use of LIT was limited to research protocols in the United States and in other countries around the world after the systematic review and meta-analysis of the Cochrane Library published in 2001 (the treatment effect on the live birth rate was not significant, with an OR of 1.22 and a CI of 0.89-1.69) [5]. However, over the past 2 decades, many researchers have suggested that LIT is an effective and safe treatment, provided that strict criteria for selecting couples to be treated, serological control for infectious diseases, and safety procedures in the laboratory during the preparation of the immunization [6][7][8][9].…”