Mesenchymal stem cell as salvage treatment for refractory chronic GVHD.
Refractory chronic GVHD (cGVHD) is an important complication after allogeneic hematopoietic SCT and is prognostic of poor outcome. MSCs are involved in tissue repair and modulating immune responses in vitro and in vivo. From April 2005 to October 2008, 19 patients with refractory cGVHD were treated with MSCs derived from the BM of volunteers. The median dose of MSCs was 0.6 × 10(6) cells per kg body weight. Fourteen of 19 patients (73.7%) responded well to MSCs, achieving a CR (n=4) or a PR (n=10). The immunosuppressive agent could be tapered to less than 50% of the starting dose in 5 of 14 surviving patients, and five patients could discontinue immunosuppressive agents. The median duration between MSC administration and immunosuppressive therapy discontinuation was 324 days (range, 200-550 days). No patients experienced adverse events during or immediately after MSC infusion. The 2-year survival rate was 77.7% in this study. Clinical improvement was accompanied by the increasing ratio of CD5+CD19+/CD5-CD19+ B cells and CD8+CD28-/CD8+CD28+ T cells. In conclusion, transfusion of MSCs expanded in vitro, irrespective of the donor, might be a safe and effective salvage therapy for patients with steroid-resistant, cGVHD.
Weng
J Y
JY
Department of Haematology, Guangdong General Hospital, Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, PR China.
Du
X
X
Geng
S X
SX
Peng
Y W
YW
Wang
Z
Z
Lu
Z S
ZS
Wu
S J
SJ
Luo
C W
CW
Guo
R
R
Ling
W
W
Deng
C X
CX
Liao
P J
PJ
Xiang
A P
AP
D000293:Adolescent; D000328:Adult; D002908:Chronic Disease; D005260:Female; D006086:Graft vs Host Disease / Q000175:diagnosis / Q000517:prevention & control / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects*; D006801:Humans; D007166:Immunosuppressive Agents / Q000008:administration & dosage; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D016879:Salvage Therapy / Q000379:methods*; D016896:Treatment Outcome; D055815:Young Adult
D007166:Immunosuppressive Agents
Blood. 2004 Dec 1;104(12):3501-6
15292060
Blood. 2005 Sep 1;106(5):1755-61
15905186
Tissue Eng. 1995 Winter;1(4):345-53
19877898
Bone Marrow Transplant. 1996 Jun;17(6):1105-11
8807122
J Immunol. 2006 Mar 1;176(5):2864-71
16493043
Transplant Proc. 2005 Jan-Feb;37(1):292-4
15808623
Stem Cells. 2006 Apr;24(4):1020-9
16339642
J Intern Med. 2007 Nov;262(5):509-25
17949362
Biol Blood Marrow Transplant. 2005 Dec;11(12):945-56
16338616
Mol Cell Biochem. 2007 Oct;304(1-2):167-79
17530189
Biol Blood Marrow Transplant. 2005 May;11(5):389-98
15846293
Br J Haematol. 2005 Aug;130(3):409-17
16042691
Biol Blood Marrow Transplant. 2005 Jan;11(1):47-55
15625544
Am J Med. 1980 Aug;69(2):204-17
6996481
Blood. 2002 Jul 1;100(1):48-51
12070007
Leukemia. 2007 Nov;21(11):2271-6
17611560
Immunol Rev. 2001 Aug;182:201-6
11722635
Lancet. 2004 May 1;363(9419):1439-41
15121408
J Gene Med. 2003 Dec;5(12):1028-38
14661178
Autoimmun Rev. 2009 Feb;8(4):349-53
19041428
Biol Blood Marrow Transplant. 2003 Apr;9(4):215-33
12720215
Proc Natl Acad Sci U S A. 2003 Jul 8;100(14):8407-11
12815096
Transplant Proc. 2001 Feb-Mar;33(1-2):104-7
11266729
Biol Blood Marrow Transplant. 2005 Apr;11(4):307-13
15812396
Science. 1999 Apr 2;284(5411):143-7
10102814
Transplantation. 2006 May 27;81(10):1390-7
16732175
Blood. 2005 Feb 15;105(4):1815-22
15494428
Stem Cells. 2005 Apr;23(4):463-70
15790766
Mol Cell Biochem. 2008 Mar;310(1-2):11-8
18060476
Blood. 2006 Jul 15;108(2):756-62
16551963
Haematologica. 2007 Jul;92(7):881-8
17606437
Bone Marrow Transplant. 2008 Mar;41(6):571-7
18026150
Transplant Proc. 2007 Jun;39(5):1710-3
17580228
Blood. 2006 Apr 15;107(8):3074-80
16368882
Biol Blood Marrow Transplant. 2006 Mar;12(3):252-66
16503494
Blood. 2004 Jun 15;103(12):4619-21
15001472
Biol Blood Marrow Transplant. 2003 Jan;9(1):38-45
12533740
Eur J Haematol. 2004 Jul;73(1):56-61
15182339
Bone Marrow Transplant. 2009 Feb;43(3):245-51
18820709