Results of a pilot study on the use of third-party donor mesenchymal stromal cells in cord blood transplantation in adults
- 1 January 2009
- journal article
- research article
- Published by Elsevier BV in Cytotherapy
- Vol. 11 (3), 278-288
- https://doi.org/10.1080/14653240902807018
Abstract
Cord blood (CB) transplants with co-infusion of third-party donor (TPD) mobilized hematopoietic stem cells (MHSC) have been shown to result in ‘bridge’ engraftment with prompt neutrophil recovery and high final rates of CB engraftment and full chimerism. This strategy overcomes the limitation posed by low cellularity of CB units for unrelated transplants in adults. Enhancement of adaptive immunity reconstitution without increasing risks of graft-versus-host disease (GvHD) is required to optimize results further. Our objectives were to evaluate co-infusion of mesenchymal stromal cells (MSC) from the same TPD regarding tolerance, CB engraftment and effects on acute (a)GvHD, both preventive and therapeutic. Ex vivo-expanded bone marrow MSC were infused at the time of the transplant or the in case of refractory aGvHD. Nine patients received 1.04–2.15 × 106/kg (median 1.20) MSC immediately after CB and TPD MHSC. Neither immediate adverse side-effects nor significant differences regarding CB engraftment or aGvHD development were observed. Four patients developed grade II aGvHD, refractory to steroids in two. These reached complete remission after therapeutic infusions of MSC. In recipients of ‘dual CB/TPD MHSC transplants’, MSC infusions were therapeutically effective for severe aGvHD but no significant differences in CB engraftment and incidence of severe aGvHD were observed following their prophylactic use. Although results of this study alone cannot conclusively determine the application of MSC in CB transplantation, we believe that, in this setting, the best use of MSC could be as pre-emptive treatment for aGvHD.Keywords
This publication has 21 references indexed in Scilit:
- Immune reconstitution after cord blood transplants supported by coinfusion of mobilized hematopoietic stem cells from a third party donorBone Marrow Transplantation, 2009
- Cord blood transplants supported by co-infusion of mobilized hematopoietic stem cells from a third-party donorBone Marrow Transplantation, 2008
- The correlation between cotransplantation of mesenchymal stem cells and higher recurrence rate in hematologic malignancy patients: outcome of a pilot clinical studyLeukemia, 2008
- Cotransplantation of ex vivo–expanded mesenchymal stem cells accelerates lymphocyte recovery and may reduce the risk of graft failure in haploidentical hematopoietic stem-cell transplantationBlood, 2007
- Transplantation of mesenchymal stem cells to enhance engraftment of hematopoietic stem cellsLeukemia, 2007
- Mesenchymal Stem Cells for Treatment of Therapy-Resistant Graft-versus-Host DiseaseTransplantation, 2006
- Mesenchymal stem cells remain of host origin even a long time after allogeneic peripheral blood stem cell or bone marrow transplantationExperimental Hematology, 2005
- Cotransplantation of HLA-Identical Sibling Culture-Expanded Mesenchymal Stem Cells and Hematopoietic Stem Cells in Hematologic Malignancy PatientsTransplantation and Cellular Therapy, 2005
- Unrelated umbilical cord blood transplants in adults: Early recoveryof neutrophils by supportive co-transplantation of a low number of highlypurified peripheral blood CD34+ cells from an HLA-haploidentical donorExperimental Hematology, 2003
- Allogeneic mesenchymal stem cell infusion for treatment of metachromatic leukodystrophy (MLD) and Hurler syndrome (MPS-IH)Bone Marrow Transplantation, 2002