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ORIGINAL RESEARCH article
Front. Immunol.
Sec. Alloimmunity and Transplantation
Volume 15 - 2024 |
doi: 10.3389/fimmu.2024.1436653
This article is part of the Research Topic Immunology of Allogeneic Hematopoietic Stem Cell Transplantation (HSCT) View all 4 articles
Human Umbilical Cord-Derived Mesenchymal Stromal Cells for the Treatment of Steroid Refractory Grades III-IV Acute Graft-versus-Host Disease with Long-Term Follow-Up
Provisionally accepted
Liangding Hu
1*
Jing-Wen Niu
2*
Yuhang Li
2*
Chen Xu
2*
Hongxia Sheng
2*
Chong Tian
2*
Hongmei Ning
2*
Jiangwei Hu
2*
Jianlin Chen
2*
Botao Li
2*
Jun Wang
2*
Xiao Lou
2*
Na Liu
2*
Yongfeng Su
2*
Yao Sun
2
Zhuoqing Qiao
2*
Lei Wang
2*
Yu Zhang
2*
Sanchun Lan
2*
Jing Xie
2
Jing Ren
2
Bo Peng
2
Shenyu Wang
2*
Yanping Shi
2*
Long Zhao
2*
Yijian Zhang
2*
Hu Chen
2*
Bin Zhang
2*- 1 Department of Hematology, Fifth Medical Center of the PLA General Hospital, Beijing, China
- 2 Fifth Medical Center of the PLA General Hospital, Beijing, Beijing Municipality, China
Mesenchymal stromal cells (MSCs) have been extensively studied as a potential treatment for steroid refractory acute graft-versus-host disease (aGVHD). However, the majority of clinical trials have focused on bone marrow-derived MSCs. In this study, we report the outcomes of 86 patients with grade III-IV (82.6% grade IV) steroid refractory aGVHD who were treated with human umbilical cord-derived mesenchymal stromal cells (UC-MSCs). The patient cohort included 17 children and 69 adults. All patients received intravenous infusions of UC-MSCs at a dose of 1 × 106 cells per kg body weight, with a median of 4 infusions (ranging from 1 to 16). The median time between the onset of aGVHD and the first infusion of UC-MSCs was 7 days (ranging from 3 to 88 days). At day 28, the overall response (OR) rate was 52.3%. Specifically, 24 patients (27.9%) achieved complete remission, while 21 (24.4%) exhibited partial remission. The estimated survival probability at 100 days was 43.7%. Following a median follow-up of 108 months (ranging from 61 to 159 months), the survival rate was approximately 11.6% (10/86). Patients who developed acute lower GI tract and liver GVHD exhibited poorer OR rates at day 28 compared to those with only acute lower GI tract GVHD (22.2% vs. 58.8%; p= 0.049). No patient experienced serious adverse events. These finding suggest that UC-MSCs are safe and effective in both children and adults with steroid refractory aGVHD. UC-MSCs could be considered as a feasible treatment option for this challenging conditon. (NCT01754454).
Keywords: Hematopoietic Stem Cell Transplantation, graft-versus-host disease, Mesenchymal Stromal Cells, Umbilical Cord, long-term follow-up
Received: 22 May 2024; Accepted: 29 Jul 2024.
Copyright: © 2024 Hu, Niu, Li, Xu, Sheng, Tian, Ning, Hu, Chen, Li, Wang, Lou, Liu, Su, Sun, Qiao, Wang, Zhang, Lan, Xie, Ren, Peng, Wang, Shi, Zhao, Zhang, Chen and Zhang. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence:
Liangding Hu, Department of Hematology, Fifth Medical Center of the PLA General Hospital, Beijing, China
Jing-Wen Niu, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Yuhang Li, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Chen Xu, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Hongxia Sheng, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Chong Tian, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Hongmei Ning, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Jiangwei Hu, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Jianlin Chen, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Botao Li, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Jun Wang, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Xiao Lou, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Na Liu, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Yongfeng Su, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Zhuoqing Qiao, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Lei Wang, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Yu Zhang, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Sanchun Lan, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Shenyu Wang, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Yanping Shi, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Long Zhao, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Yijian Zhang, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Hu Chen, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
Bin Zhang, Fifth Medical Center of the PLA General Hospital, Beijing, 100049, Beijing Municipality, China
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