[Clinical study of umbilical cord-derived mesenchymal stem cells for treatment of nineteen patients with steroid-resistant severe acute graft-versus-host disease].
OBJECTIVE
To evaluate the safety and efficacy of umbilical cord-derived mesenchymal stem cells (MSCs) infusion in patients with steroid-resistant severe acute graft-versus-host disease (aGVHD).


METHODS
A total of 19 patients with steroid-resistant severe aGVHD received MSCs infusion treatment. The treatment response, transplantation-related mortality, events associated with infusion and relapse rate were analyzed.


RESULTS
Two patients with grade II, 5 patients with grade III and 12 patients with grade IV aGVHD received a total of 58 infusions of MSCs. The mean total dose of MSCs was 2.13 (range 0.60 - 7.20)×10(6) cells per kg bodyweight. Seven patients received one infusion, 2 patients received two infusions, and 10 patients received three or more infusions. Eleven patients had a complete response and 4 had a partial response and 4 had no response. No patients had side-effects during or immediately after infusions, and no MSCs related tumorigenesis was detected to date. Eleven patients survived and 8 died, 4 for aGVHD, 1 for infection and 2 for aGVHD with concomitant infection and 1 for underlying leukemia relapse. The cell viability of freshly prepared MSCs is 93% (92% - 95%) by trypan blue staining. The cell viability of programmatically frozen and thawed MSCs is 72% (70% - 74%).


CONCLUSIONS
Infusion of umbilical cord-derived MSCs expanded in vitro is an effective therapy for patients with steroid-resistant severe aGVHD without negative impact on relapse. Freshly prepared MSCs are superior to frozen and thawed cells in terms of cell viability.
First Affiliated Hospital of Soochow University, Suzhou, China.
Guang-hua
GH
Chen
Ting
T
Yang
Hong
H
Tian
Man
M
Qiao
Hui-wen
HW
Liu
Cheng-cheng
CC
Fu
Miao
M
Miao
Zheng-min
ZM
Jin
Xiao-wen
XW
Tang
Yue
Y
Han
Guang-sheng
GS
He
Xu-hui
XH
Zhang
Xiao
X
Ma
Feng
F
Chen
Xiao-hui
XH
Hu
Sheng-li
SL
Xue
Ying
Y
Wang
Hui-ying
HY
Qiu
Ai-ning
AN
Sun
Zhi-zhe
ZZ
Chen
De-pei
DP
Wu
D000293:Adolescent; D000328:Adult; D036101:Cord Blood Stem Cell Transplantation; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000601:surgery*; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D059630:Mesenchymal Stem Cells; D008875:Middle Aged; D013256:Steroids / Q000494:pharmacology; D015996:Survival Rate; D014470:Umbilical Cord / Q000166:cytology; D055815:Young Adult
D013256:Steroids