| Autor: |
Jingwen Niu, Yuhang Li, Chen Xu, Hongxia Sheng, Chong Tian, Hongmei Ning, Jiangwei Hu, Jianlin Chen, Botao Li, Jun Wang, Xiao Lou, Na Liu, Yongfeng Su, Yao Sun, Zhuoqing Qiao, Lei wang, Yu zhang, Sanchun Lan, Jing Xie, Jing Ren, Hu Chen, Bin Zhang, Liangding Hu |
| Rok vydání: |
2022 |
| Popis: |
Background: Acute graft-versus-host disease (aGVHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. First-line treatment of aGVHD is corticosteroid. Second-line therapy mainly comprises immunosuppressants. However, ∼ 25% of the patients have a steroid-resistant and therapy-refractory disease, which is associated with a very poor prognosis. An alternative therapy option for steroid-refractory and therapy-refractory aGVHD is the use of mesenchymal stromal cells (MSCs). Here, we report the results of 88 patients with grade III-IV aGVHD treated with human umbilical cord derived mesenchymal stromal cells (UC-MSC). Methods: There were 18 children and 70 adults with grade III/ IV aGVHD (82% grade IV). These patients were either resistant to steroids or refractory to 1–5 additional immunosuppressants. UC-MSCs were transfused at a median dose of 1 × 106 cells/kg with a median of 4 times (range, 1 to 16). Results: Median time between the onset of aGVHD and the first infusion of UC-MSC was 7 days (range, 3–88). The day 28 overall response rate was 51.14%, of these, 24 patients (27.27%) showed complete remission (CR), 21 (23.86%) showed partial remission (PR). The estimated survival probability at 100 days was 43.3%. And after a median follow-up of 66 months (26–122 months), the survival rate was approximately 33% (29/88). Patients developed acute gastrointestinal (GI) tract and liver GVHD showed worse overall response in day 28 than patients only with acute GI GVHD (21% vs. 58%; p= 0.037). No patient had severe side effects. Conclusions: These results suggest that UC-MSC treatment was safe and effective in children and adults, and should be considered for treating steroid-refractory aGVHD. Trial registration: ClinicalTrials: NCT01754454. Registered 21 December 2012 - Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT01754454?cond=msc+gvhd&draw=2&rank=8 |
| Databáze: |
OpenAIRE |
| Externí odkaz: |
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