The Effect of Moringa oleifera on Hematological Parameters in Chemotherapy-Induced Anemia: A Systematic Review and Meta-analysis

Background: Chemotherapy-induced anemia (CIA) is a common complication caused by bone marrow suppression in patients receiving chemotherapy. Standard treatments, including erythropoiesisstimulating agents, blood transfusions, and intravenous iron, are often limited by side effects, high costs, and poor accessibility. Moringa oleifera, rich in iron, calcium, vitamin C, flavonoids, and polyphenols, exhibits hematopoietic and antioxidative properties in preclinical studies. This systematic review and meta-analysis assessed the effects of M. oleifera on hematologic parameters in chemotherapy-induced anemia models. Methods: A systematic search of PubMed, Cochrane Library, Scopus, PMC, and ProQuest (April–June 2025) was performed following PRISMA 2020 guidelines. Eligible studies investigated M. oleifera in chemotherapy- or chemically-induced anemia and reported hemoglobin (Hb), red blood cell (RBC) count, or packed cell volume (PCV). Data were analyzed using SYRCLE’s risk-of-bias tool and a random-effects model. Results: Eight preclinical studies met inclusion criteria. M. oleifera significantly increased Hb (MD= 2.97, 95% CI 1.96–3.97), RBC (MD = 0.73, 95% CI 0.14–1.31), and PCV (MD = 11.96, 95% CI 2.89–21.03). Substantial heterogeneity (I² = 67–95%) was observed. Conclusions: Moringa oleifera improved hematological parameters in preclinical CIA models. Further clinical trials are needed to confirm efficacy, safety, and optimal dosage in humans.