*Purpose: After patients received hematopoietic stem cell transplantation (HSCT) ,both cyclosporine (CsA) and tacrolimus (TAC) in combination with methotrexate (MTX) have been recommended as standard prophylaxis strategy for GVHD by European Group of Blood and Marrow Transplantation (EBMT). However, the advantage of TAC combined with MTX lacks conclusive evidence.

*Methods: We searched online databases for studies on the comparsion of CsA+MTX and TAC+MTX on patients received HSCT. Odds ratio (OR) and 95% confidence interval (CI) was applied to compare the pooled data.

*Results: We found that there is a significant reduction of Grade II to IV aGVHD(OR 0.42; [CI], 0.28-0.61; p<0.00001), Grade III to IV aGVHD (OR 0.59; [CI], 0.38-0.92; p=0.02), chronic GVHD (OR 0.79; [CI], 0.62-1.00; p=0.05)and non-relapse mortality (OR 0.62; [CI], 0.40-0.95; p=0.03), and increased OS rate (only in those received from unrelated donor) (OR 1.30; [CI], 1.15-1.48; p<0.0001)in TAC+MTX group. And similar outcomes occurred in relapse rate and disease free survival rate in both groups.

*Conclusions: We conclude that TAC+MTX is superior to CsA+MTX on the prevention aGVHD in patients received HSCT, which further prolongs OS in some specific populations. Further studies are still required to evaluate effect of TAC or CsA combined with other suppressors in the therapy of HSCT.

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