title: Cotransplantation of haploidentical hematopoietic and umbilical cord mesenchymal stem cells with a myeloablative regimen for refractory/relapsed hematologic malignancy.
abstract: Human leukocyte antigen haploidentical hematopoietic stem-cell transplantation (haplo-HSCT) is associated with an increased risk of graft failure and severe graft-versus-host disease (GVHD). Mesenchymal stromal cells (MSCs) have been shown to support in vivo normal hematopoiesis and to display potent immunesuppressive effects. We cotransplanted the culture-expanded third-party donor-derived umbilical cord MSCs (UC-MSCs) in 50 people with refractory/relapsed hematologic malignancy undergoing haplo-HSCT with myeloablative conditioning. We observed that all patients given MSCs showed sustained hematopoietic engraftment without any adverse UC-MSC infusion-related reaction. The median times to neutrophil >0.50 × 10(9)/L and platelet >20 × 10(9)/L engraftment were 12.0 and 15.0 days, respectively. We did not observe an increase in severe acute GVHD (aGVHD) and extensive chronic GVHD (cGVHD), too. Grade II-IV aGVHD was observed in 12 of 50 (24.0 %) patients. cGVHD was observed in 17 of 45 (37.7 %) patients and was extensive in 3 patients. Additionally, only five patients (10.0 %) experienced relapse at a median time to progression of 192 days. The probability that patients would attain progression-free survival at 2 years was 66.0 %. The results indicate that this new strategy is effective in improving donor engraftment and reducing severe GVHD, which will provide a feasible option for the therapy of high-risk hematologic malignancy.
authors.affiliation: Department of Hematology, 304th Clinical Division, Chinese PLA General Hospital, 51 FuCheng Road, Beijing, 100048, China.
authors.forename: Yamei
authors.initials: Y
authors.lastname: Wu
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Wang
authors.forename: Yongbin
authors.initials: Y
authors.lastname: Cao
authors.forename: Lixin
authors.initials: L
authors.lastname: Xu
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Li
authors.forename: Pei
authors.initials: P
authors.lastname: Liu
authors.forename: Pei
authors.initials: P
authors.lastname: Yan
authors.forename: Zhouyang
authors.initials: Z
authors.lastname: Liu
authors.forename: Dandan
authors.initials: D
authors.lastname: Zhao
authors.forename: Jing
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaoxiong
authors.initials: X
authors.lastname: Wu
authors.forename: Chunji
authors.initials: C
authors.lastname: Gao
authors.forename: Wanming
authors.initials: W
authors.lastname: Da
authors.forename: Zhongchao
authors.initials: Z
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D036101:Cord Blood Stem Cell Transplantation / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D019337:Hematologic Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000379:methods*; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D055815:Young Adult