title: Mesenchymal stem cell as salvage treatment for refractory chronic GVHD.
abstract: 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.
authors.affiliation: Department of Haematology, Guangdong General Hospital, Academy of Medical Sciences, 106 Zhongshan Er Road, Guangzhou, Guangdong, PR China.
authors.forename: J Y
authors.initials: JY
authors.lastname: Weng
authors.forename: X
authors.initials: X
authors.lastname: Du
authors.forename: S X
authors.initials: SX
authors.lastname: Geng
authors.forename: Y W
authors.initials: YW
authors.lastname: Peng
authors.forename: Z
authors.initials: Z
authors.lastname: Wang
authors.forename: Z S
authors.initials: ZS
authors.lastname: Lu
authors.forename: S J
authors.initials: SJ
authors.lastname: Wu
authors.forename: C W
authors.initials: CW
authors.lastname: Luo
authors.forename: R
authors.initials: R
authors.lastname: Guo
authors.forename: W
authors.initials: W
authors.lastname: Ling
authors.forename: C X
authors.initials: CX
authors.lastname: Deng
authors.forename: P J
authors.initials: PJ
authors.lastname: Liao
authors.forename: A P
authors.initials: AP
authors.lastname: Xiang
mesh_terms: 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
chemical_list: D007166:Immunosuppressive Agents
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