Clinical evaluation of haploidentical hematopoietic combined with human umbilical cord-derived mesenchymal stem cells in severe aplastic anemia

Autor: Xue-Liang Yang, Xiao-Xiong Wu, Wanming Da, Bei Yan, Li-Xin Xu, Song-Wei Li, Xiao-Hong Li, Ya-Mei Wu, Zhou-Yang Liu, Yongbin Cao
Rok vydání: 2017
Předmět:
0301 basic medicine
Adult
Male
Haploidentical hematopoietic stem cells transplantation
medicine.medical_specialty
Transplantation Conditioning
Severe aplastic anemia
Cyclophosphamide
medicine.medical_treatment
lcsh:Medicine
Graft vs Host Disease
Hematopoietic stem cell transplantation
Mesenchymal Stem Cell Transplantation
Graft versus host disease
Umbilical cord
Gastroenterology
03 medical and health sciences
0302 clinical medicine
Internal medicine
medicine
Humans
business.industry
Research
lcsh:R
Hematopoietic Stem Cell Transplantation
Anemia
Aplastic
Mesenchymal Stem Cells
General Medicine
Middle Aged
medicine.disease
Tissue Donors
Umbilical cord-derived mesenchymal stem cells
Fludarabine
030104 developmental biology
medicine.anatomical_structure
Graft-versus-host disease
030220 oncology & carcinogenesis
Transplantation
Haploidentical
Female
Stem cell
business
Busulfan
medicine.drug
Zdroj: European Journal of Medical Research
European Journal of Medical Research, Vol 23, Iss 1, Pp 1-8 (2018)
ISSN: 2047-783X
Popis: Background This study not only evaluated the clinical effects of treatment using haploidentical hematopoietic stem cells (haplo-HSCs) combined with human umbilical cord mesenchymal stem cells (UC-MSCs) in patients with severe aplastic anemia (SAA), but also investigated the factors related to graft versus host disease (GVHD). Methods Cotransplantation of haplo-HSCs and UC-MSCs was performed in 24 SAA patients. The conditioning regimens consisted of rabbit anti-human T-lymphocyte immunoglobulin (ATG), cyclophosphamide, and fludarabine with or without busulfan. GVHD was prevented using cyclosporine A, ATG, anti-CD25 monoclonal antibody, and mycophenolate material. Results The incidence of acute GVHD was 50%. The incidence of severe acute GVHD was not related to gender, age, donor-recipient relations, and patient/donor pair, while patient/donor pair (r = 0.541, P = 0.022) was significantly correlated with incidence of chronic GVHD. Upon follow-up for a median of 13 months, 5 of the 24 patients (20.8%) were dead. The survival rates at 3 and 6 months in all patients were 87.5% (21/24) and 83.3% (20/24), respectively. Conclusion Cotransplantation of haplo-HSCs combined with UC-MSCs was an effective and safe approach for the treatment of patients with SAA. The appropriate conditioning regimen and early treatment for infection also played a critical role in the success of HSCT. Electronic supplementary material The online version of this article (10.1186/s40001-018-0311-3) contains supplementary material, which is available to authorized users.
Databáze: OpenAIRE
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