Allogeneic mesenchymal stem cell therapy for refractory cytopenias after hematopoietic stem cell transplantation.
BACKGROUND
Posttransplant cytopenias are a severe complication after allogeneic stem cell transplantation (allo-SCT) and their origin is often multifactorial or unknown. They are frequently refractory to standard therapy, which may include steroids and/or immunoglobulins. Mesenchymal stem cells (MSCs) are an attractive therapeutic tool in the allo-SCT setting for the ability to enhance engraftment as well as acting as immunosuppressants for graft-versus-host disease. There is no prior experience in the literature of the use of MSCs to treat cytopenias after allo-SCT.


METHODS
In this work we report for the first time four cases of refractory posttransplant cytopenias (three patients with thrombocytopenia and one with neutropenia) that were treated with MSCs from a third-party donor. MSCs were expanded from 100 mL of marrow obtained under standard good manufacturing practice conditions. Most patients received more than one cell dose, and median dose of MSCs administered was 1 × 10(6) /kg.


RESULTS
All patients recovered normal blood counts, with a mean follow-up of 12.5 months. There were no adverse events related to MSC administration.


CONCLUSIONS
MSC therapy may contribute to the recovery of refractory posttransplant peripheral cytopenias in patients undergoing allo-SCT.
Servicio de Hematología, Hospital Universitario de Salamanca; the Centro en Red de Medicina Regenerativa y Terapia Celular de Castilla y León; and the Centro de Investigación del Cáncer-IBMCC (Universidad de Salamanca-CSIC), Salamanca, Spain. ferminsg@usal.es
Fermin M
FM
Sánchez-Guijo
Olga
O
López-Villar
Lucía
L
López-Anglada
Eva M
EM
Villarón
Sandra
S
Muntión
María
M
Díez-Campelo
Jose A
JA
Perez-Simón
Jesús F
JF
San Miguel
Dolores
D
Caballero
Maria-Consuelo
MC
del Cañizo
D000328:Adult; D018380:Hematopoietic Stem Cell Transplantation; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects; D009503:Neutropenia / Q000601:surgery*; D013921:Thrombocytopenia / Q000601:surgery*; D014184:Transplantation, Homologous