Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease.

Autor: Donadel CD; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Pires BG; Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., André NC; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Costa TCM; Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Orellana MD; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Caruso SR; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Seber A; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil.; Hospital Samaritano, São Paulo 01232-010, Brazil., Ginani VC; Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil.; Hospital Samaritano, São Paulo 01232-010, Brazil., Gomes AA; Hospital Sírio Libanês, São Paulo 01308-050, Brazil., Novis Y; Hospital Sírio Libanês, São Paulo 01308-050, Brazil., Barros GMN; Barretos Cancer Hospital, Barretos 14784-400, Brazil., Vilella NC; Barretos Cancer Hospital, Barretos 14784-400, Brazil., Martinho GH; Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil., Vieira AK; Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil., Kondo AT; Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil., Hamerschlak N; Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil., Filho JS; Hospital A.C.Camargo Cancer Center, São Paulo 01525-001, Brazil., Xavier EM; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05403-010, Brazil., Fernandes JF; Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil.; Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil., Rocha V; Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05403-010, Brazil., Covas DT; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil.; Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Calado RT; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil.; Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., Guerino-Cunha RL; Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil., De Santis GC; Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil.; Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil.
Jazyk: angličtina
Zdroj: Pharmaceuticals (Basel, Switzerland) [Pharmaceuticals (Basel)] 2023 Mar 30; Vol. 16 (4). Date of Electronic Publication: 2023 Mar 30.
DOI: 10.3390/ph16040512
Abstrakt: Background: Steroid-refractory acute graft-vs.-host disease (SR-aGVHD) is a complication of allogeneic hematopoietic stem cell transplantation with a dismal prognosis and for which there is no consensus-based second-line therapy. Ruxolitinib is not easily accessible in many countries. A possible therapy is the administration of mesenchymal stromal cells (MSCs).
Methods: In this retrospective study, 52 patients with severe SR-aGVHD were treated with MSCs from umbilical cord (UC-MSCs) in nine institutions.
Results: The median (range) age was 12.5 (0.3-65) years and the mean ± SD dose (×10 6 /kg) was 4.73 ± 1.3 per infusion (median of four infusions). Overall (OR) and complete response (CR) rates on day 28 were 63.5% and 36.6%, respectively. Children ( n = 35) had better OR (71.5% vs. 47.1%, p = 0.12), CR (48.6% vs. 11.8%, p = 0.03), overall survival ( p = 0.0006), and relapse-free survival ( p = 0.0014) than adults ( n = 17). Acute adverse events (all of them mild or moderate) were detected in 32.7% of patients, with no significant difference in children and adult groups ( p = 1.0).
Conclusions: UC-MSCs are a feasible alternative therapy for SR-aGVHD, especially in children. The safety profile is favorable.
Databáze: MEDLINE
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