期刊
BIOLOGY OF BLOOD AND MARROW TRANSPLANTATION
卷 18, 期 4, 页码 557-564出版社
ELSEVIER SCIENCE INC
DOI: 10.1016/j.bbmt.2011.07.023
关键词
Hematopoietic stem cell transplantation; Graft-versus-host disease; Mesenchymal stem cells
资金
- Swedish Cancer Society [CAN 2008/562, 09/0712]
- Children's Cancer Foundation [06/094, 08/071]
- Swedish Research Council [K2008-64X-05971-28-3, K2006-32X-14716-04-1, K2008-64X-20742-01-3, K2008-64P-15457-04-3]
- Cancer Society in Stockholm
- Karolinska Institutet
- Tobias Foundation
- Swedish Society of Medicine, Stockholm County Council
- Sven and Ebba-Christina Hagberg Foundation
Thirty-one patients treated with mesenchymal stromal cells (MSCs) for acute graft-versus-host disease (aGVHD) or hemorrhagic cystitis between 2002 and 2007 were followed to investigate predictors of outcome, immunologic effects in vivo, and long-term survival. There was no correlation between in vitro suppression by MSCs in mixed lymphocyte cultures and outcome. Soluble IL-2 receptors were measured in blood before and after MSC infusion and declined significantly during the first week after MSC infusion (P = .03). Levels of interleukin-6 and HLA-G were unaffected. Infectious complications occurred several years after recovery from aGVHD. Cytomegalovirus viral load was high, and cytomegalovirus disease was common. Among patients recovering from aGVHD, 54% died of late infections, between 4 months and 2 years after MSC treatment. No increase in leukemia relapse or graft rejection was found. Children had a better survival rate than adults (P = .005). In GVHD patients, 1-year survival was 75% in patients who received early-passage MSCs (from passages 1-2) in contrast to 21% using later passage MSCs (from passages 3-4) (P < .01). We conclude that treatment with early-passage MSCs improved survival in patients with therapy-resistant GVHD. Death from infection was common in MSC-treated patients, but there was no increase in leukemia relapse. Biol Blood Marrow Transplant 18: 557-564 (2012) (C) 2012 American Society for Blood and Marrow Transplantation
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