title: Haploidentical hematopoietic stem cell transplant with umbilical cord-derived multipotent mesenchymal cell infusion for the treatment of high-risk acute leukemia in children.
abstract: In this study, 25 children with high-risk acute leukemia received haploidentical hematopoietic stem cell transplant (haplo-HSCT) with co-transfusion of umbilical cord multipotent mesenchymal cells (UC-MSCs). Adverse effects, hematopoietic recovery, complications and outcome were observed during a median follow-up of 12.8 months (range: 3-25 months). Myeloid engraftment was rapid, and the median time to neutrophil and platelet recovery was 15.12 days and 20.08 days, respectively. Eight patients developed grade I skin acute graft-versus-host disease (aGVHD) that responded well to standard steroid therapy. Of note, cytomegalovirus viremia was observed in most patients (23/25 cases). Patients died mainly of leukemia relapse and pulmonary complication. Fourteen patients are currently alive and remain with full donor chimerism at the time of reporting. The present results suggest further clinical trials to testify the effectiveness of UC-MSCs to prevent aGVHD in haplo-HSCT for treating children with high-risk leukemia.
authors.affiliation: Department of Hematology, Air Force General Hospital , PLA, Beijing , China.
authors.forename: Ling
authors.initials: L
authors.lastname: Zhu
authors.forename: Zhidong
authors.initials: Z
authors.lastname: Wang
authors.forename: Xiaoli
authors.initials: X
authors.lastname: Zheng
authors.forename: Li
authors.initials: L
authors.lastname: Ding
authors.forename: Dongmei
authors.initials: D
authors.lastname: Han
authors.forename: Hongmin
authors.initials: H
authors.lastname: Yan
authors.forename: Zikuan
authors.initials: Z
authors.lastname: Guo
authors.forename: Hengxiang
authors.initials: H
authors.lastname: Wang
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006085:Graft Survival; D006086:Graft vs Host Disease / Q000209:etiology; D006239:Haplotypes; D018380:Hematopoietic Stem Cell Transplantation / Q000009:adverse effects; D006801:Humans; D007938:Leukemia / Q000401:mortality / Q000628:therapy*; D008297:Male; D045164:Mesenchymal Stem Cell Transplantation / Q000009:adverse effects; D018183:Transplantation Chimera; D014184:Transplantation, Homologous; D016896:Treatment Outcome; D014470:Umbilical Cord / Q000166:cytology
keywords: Children's leukemia; HLA-haploidentical; graft-versus-host disease; hematopoietic stem cell transplant; multipotent mesenchymal cells; relapse