title: Unrelated allogeneic bone marrow-derived mesenchymal stem cells for steroid-refractory acute graft-versus-host disease: a phase I/II study.
abstract: We conducted a multicenter phase I/II study using mesenchymal stem cells (MSCs) manufactured from the bone marrow of healthy unrelated volunteers to treat steroid-refractory acute graft-versus-host disease (aGVHD). Fourteen patients with hematological malignancies who suffered from grade II (9 patients) or III aGVHD (5) were treated. Affected organs were gut (10 patients), skin (9 patients), and liver (3 patients). Seven patients had two involved organs. The median age was 52. No other second-line agents were given. MSCs were given at a dose of 2 × 10(6) cells/kg for each infusion twice a week for 4 weeks. If needed, patients were continuously given MSCs weekly for an additional 4 weeks. By week 4, 13 of 14 patients (92.9 %) had responded to MSC therapy with a complete response (CR; n = 8) or partial response (PR; n = 5). At 24 weeks, 11 patients (10 with CR and 1 with PR) were alive. At 96 weeks, 8 patients were alive in CR. A total of 6 patients died, attributable to the following: underlying disease relapse (2 patients), breast cancer relapse (1), veno-occlusive disease (1), ischemic cholangiopathy (1), and pneumonia (1). No clear adverse effects associated with MSC infusion were observed. Third party-derived bone marrow MSCs may be safe and effective for patients with steroid-refractory aGVHD.
authors.affiliation: Division of Cell Transplantation and Transfusion, Jichi Medical University Hospital, 3311-1 Yakushiji, Shimotsuke, Tochigi 329-0498, Japan. muroi-kz@jichi.ac.jp
authors.forename: Kazuo
authors.initials: K
authors.lastname: Muroi
authors.forename: Koichi
authors.initials: K
authors.lastname: Miyamura
authors.forename: Kazuteru
authors.initials: K
authors.lastname: Ohashi
authors.forename: Makoto
authors.initials: M
authors.lastname: Murata
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Eto
authors.forename: Naoki
authors.initials: N
authors.lastname: Kobayashi
authors.forename: Shuichi
authors.initials: S
authors.lastname: Taniguchi
authors.forename: Masahiro
authors.initials: M
authors.lastname: Imamura
authors.forename: Kiyoshi
authors.initials: K
authors.lastname: Ando
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kato
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.forename: Takanori
authors.initials: T
authors.lastname: Teshima
authors.forename: Masaki
authors.initials: M
authors.lastname: Mori
authors.forename: Keiya
authors.initials: K
authors.lastname: Ozawa
mesh_terms: D000328:Adult; D064591:Allografts; D001854:Bone Marrow Cells; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006086:Graft vs Host Disease / Q000209:etiology / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D019337:Hematologic Neoplasms / Q000401:mortality / Q000628:therapy; D006801:Humans; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation; D008875:Middle Aged; D015996:Survival Rate; D061349:Unrelated Donors