Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation
Purpose: Graft- versus -host disease (GVHD) is an important complication after human leukocyte antigen (HLA) haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT), which may lead to poor prognosis. Our study intends to identify the efficacy and safety of mesenchymal stem cells (M...
| Main Authors: | , , , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2022-01-01
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| Series: | Therapeutic Advances in Hematology |
| Online Access: | https://doi.org/10.1177/20406207211072838 |
| _version_ | 1818985474330460160 |
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| author | Meng-Zhu Shen Xin-Xin Liu Zhi-Yuan Qiu Lan-Ping Xu Xiao-Hui Zhang Yu Wang Chen-Hua Yan Huan Chen Yu-Hong Chen Wei Han Feng-Rong Wang Jing-Zhi Wang Si-Ning Liu Kai-Yan Liu Xiao-Jun Huang Xiao-Dong Mo |
| author_facet | Meng-Zhu Shen Xin-Xin Liu Zhi-Yuan Qiu Lan-Ping Xu Xiao-Hui Zhang Yu Wang Chen-Hua Yan Huan Chen Yu-Hong Chen Wei Han Feng-Rong Wang Jing-Zhi Wang Si-Ning Liu Kai-Yan Liu Xiao-Jun Huang Xiao-Dong Mo |
| author_sort | Meng-Zhu Shen |
| collection | DOAJ |
| description | Purpose: Graft- versus -host disease (GVHD) is an important complication after human leukocyte antigen (HLA) haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT), which may lead to poor prognosis. Our study intends to identify the efficacy and safety of mesenchymal stem cells (MSCs) for multidrug-resistant (MDR)-GVHD after HID HSCT. Methods: MDR-GVHD was referring to GVHD remaining no response to at least two types of therapy, and hUCB-MSCs were given at the dose of (1.0–2.0) × 10 6 /kg once a week. Results: A total of 21 patients were enrolled in this retrospective study (acute GVHD (aGVHD): n = 14, chronic GVHD (cGVHD): n = 7). The median dose of MSCs was 1.2 × 10 6 cells/kg (range, 0.8–1.8 × 10 6 ) cells/kg, and the median numbers of infusion were 2 (range, 1–7) and 3 (range, 2–12) for MDR-aGVHD and MDR-cGVHD patients, respectively. In MDR-aGVHD patients, the overall response rate (ORR) was 57.1%, including 50.0% complete response (CR) and 7.1% partial response (PR), and the median time to response was 49.5 days (range, 16–118) days. The 2-year probability of overall survival after MSCs was 64.3%. Five patients (35.7%) developed infections after MSCs, and no obvious hematologic toxicities were observed. Five MDR-aGVHD patients died after MSCs treatments because of GVHD progression ( n = 1), severe infection (bacterial central nervous system infection: n = 1; fungal pneumonia: n = 2), and poor graft function ( n = 1). In MDR-cGVHD patients, three patients (42.9%) achieved PR after MSCs and the median time to response was 56 days (22–84) days. The ORRs for moderate and severe cGVHD were 50.0% and 33.3%, respectively. Four MDR-cGVHD patients died after MSCs treatments because of GVHD progression ( n = 2), severe fungal pneumonia ( n = 1), and relapse ( n = 1). Conclusion: MSCs treatment may be safe and effective for MDR-GVHD after HID HSCT. |
| first_indexed | 2024-12-20T18:35:28Z |
| format | Article |
| id | doaj.art-44771582a1ed44e18367d168931f1ad5 |
| institution | Directory Open Access Journal |
| issn | 2040-6215 |
| language | English |
| last_indexed | 2024-12-20T18:35:28Z |
| publishDate | 2022-01-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Therapeutic Advances in Hematology |
| spelling | doaj.art-44771582a1ed44e18367d168931f1ad52022-12-21T19:29:56ZengSAGE PublishingTherapeutic Advances in Hematology2040-62152022-01-011310.1177/20406207211072838Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantationMeng-Zhu ShenXin-Xin LiuZhi-Yuan QiuLan-Ping XuXiao-Hui ZhangYu WangChen-Hua YanHuan ChenYu-Hong ChenWei HanFeng-Rong WangJing-Zhi WangSi-Ning LiuKai-Yan LiuXiao-Jun HuangXiao-Dong MoPurpose: Graft- versus -host disease (GVHD) is an important complication after human leukocyte antigen (HLA) haploidentical donor (HID) hematopoietic stem cell transplantation (HSCT), which may lead to poor prognosis. Our study intends to identify the efficacy and safety of mesenchymal stem cells (MSCs) for multidrug-resistant (MDR)-GVHD after HID HSCT. Methods: MDR-GVHD was referring to GVHD remaining no response to at least two types of therapy, and hUCB-MSCs were given at the dose of (1.0–2.0) × 10 6 /kg once a week. Results: A total of 21 patients were enrolled in this retrospective study (acute GVHD (aGVHD): n = 14, chronic GVHD (cGVHD): n = 7). The median dose of MSCs was 1.2 × 10 6 cells/kg (range, 0.8–1.8 × 10 6 ) cells/kg, and the median numbers of infusion were 2 (range, 1–7) and 3 (range, 2–12) for MDR-aGVHD and MDR-cGVHD patients, respectively. In MDR-aGVHD patients, the overall response rate (ORR) was 57.1%, including 50.0% complete response (CR) and 7.1% partial response (PR), and the median time to response was 49.5 days (range, 16–118) days. The 2-year probability of overall survival after MSCs was 64.3%. Five patients (35.7%) developed infections after MSCs, and no obvious hematologic toxicities were observed. Five MDR-aGVHD patients died after MSCs treatments because of GVHD progression ( n = 1), severe infection (bacterial central nervous system infection: n = 1; fungal pneumonia: n = 2), and poor graft function ( n = 1). In MDR-cGVHD patients, three patients (42.9%) achieved PR after MSCs and the median time to response was 56 days (22–84) days. The ORRs for moderate and severe cGVHD were 50.0% and 33.3%, respectively. Four MDR-cGVHD patients died after MSCs treatments because of GVHD progression ( n = 2), severe fungal pneumonia ( n = 1), and relapse ( n = 1). Conclusion: MSCs treatment may be safe and effective for MDR-GVHD after HID HSCT.https://doi.org/10.1177/20406207211072838 |
| spellingShingle | Meng-Zhu Shen Xin-Xin Liu Zhi-Yuan Qiu Lan-Ping Xu Xiao-Hui Zhang Yu Wang Chen-Hua Yan Huan Chen Yu-Hong Chen Wei Han Feng-Rong Wang Jing-Zhi Wang Si-Ning Liu Kai-Yan Liu Xiao-Jun Huang Xiao-Dong Mo Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation Therapeutic Advances in Hematology |
| title | Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation |
| title_full | Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation |
| title_fullStr | Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation |
| title_full_unstemmed | Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation |
| title_short | Efficacy and safety of mesenchymal stem cells treatment for multidrug-resistant graft--host disease after haploidentical allogeneic hematopoietic stem cell transplantation |
| title_sort | efficacy and safety of mesenchymal stem cells treatment for multidrug resistant graft host disease after haploidentical allogeneic hematopoietic stem cell transplantation |
| url | https://doi.org/10.1177/20406207211072838 |
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