The Effect of Bone Marrow-Derived Mesenchymal Stem Cells Co-transplantation with Hematopoietic Stem Cells on Liver Fibrosis Alleviation and Survival in Patients with Class III β-thalassemia Major
| Autor: | Ardeshir Ghavamzadeh, Azadeh Kiumarsi, Tahereh Rostami, Nasrollah Maleki, Amir Pejman Hashemi Taheri, Mohsen Nikbakht, Seied Aasadollah Mousavi, Amir Kasaeian, Seyed Mohammad Tavangar |
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| Rok vydání: | 2021 |
| Předmět: |
Liver Cirrhosis
0301 basic medicine medicine.medical_specialty Platelet Engraftment Liver fibrosis Graft vs Host Disease Medicine (miscellaneous) Iran Mesenchymal Stem Cell Transplantation Biochemistry Genetics and Molecular Biology (miscellaneous) Gastroenterology lcsh:Biochemistry 03 medical and health sciences 0302 clinical medicine Bone Marrow Internal medicine medicine Humans lcsh:QD415-436 Outcome lcsh:R5-920 medicine.diagnostic_test business.industry Research beta-Thalassemia Mesenchymal stem cell Hematopoietic Stem Cell Transplantation Beta thalassemia Mesenchymal Stem Cells Cell Biology Hematopoietic Stem Cells medicine.disease Transplantation 030104 developmental biology medicine.anatomical_structure Liver biopsy Molecular Medicine Liver function Bone marrow lcsh:Medicine (General) Hepatic fibrosis business 030215 immunology |
| Zdroj: | Stem Cell Research & Therapy Stem Cell Research & Therapy, Vol 12, Iss 1, Pp 1-12 (2021) |
| Popis: | Background Hepatic fibrosis is a common complication in transfusion-dependent thalassemia patients. Data on the co-transplantation of mesenchymal stem cells (MSCs) with hematopoietic stem cells (HSCs) in beta-thalassemia major patients are scarce. Therefore, we aimed to evaluate the effect of co-transplantation of bone marrow-derived MSC with HSCs on the liver fibrosis alleviation and transplant outcomes in class III beta-thalassemia major. Methods Between April 1998 and January 2017, a total of 224 consecutive patients with class III beta-thalassemia major underwent allogeneic HSCT in the Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran. To assess liver fibrotic changes after transplantation, 47 patients participated in the MSC plus HSC group and 30 patients in the HSC only group at the end of the follow-up period. All patients underwent laboratory tests, especially serum ferritin and liver function testing, hepatic T2* MRI, liver biopsy, and FibroScan before and 2 years after transplantation. Kaplan-Meier curves were derived to determine survival and were compared using the log-rank test. Repeated-measure, mixed-effect linear regression models were used to examine the changes in liver fibrosis over time. Results The 10-year OS rate was 71.84% in the mesenchymal group and 61.89% in the non-mesenchymal group (P value = 0.294), while the 10-year TFS rate was 63.64% in the mesenchymal group and 52.78% in the non-mesenchymal group (P value = 0.285). No significant difference was observed in the 10-year NRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD between the two groups. In addition, the results of repeated-measure, mixed-effect linear regression models showed that none of the variables determining hepatic fibrosis had a significant difference between patients receiving MSCs and patients who did not receive MSCs. Conclusions Based on the results of this study, a single infusion of MSCs at the time of HSCT to patients with class III beta-thalassemia major could not significantly improve the liver fibrosis alleviation and transplantation outcomes, including OS, TFS, TRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD. |
| Databáze: | OpenAIRE |
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