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Clinical Trial
. 2020 May;48(5):300060520920438.
doi: 10.1177/0300060520920438.

Pre-infusion single-dose mesenchymal stem cells promote platelet engraftment and decrease severe acute graft versus host disease without relapse in haploidentical peripheral blood stem cell transplantation

Xiaoning Wang  1 , Mei Zhang  1 , Pengcheng He  1
Affiliations
Clinical Trial

Pre-infusion single-dose mesenchymal stem cells promote platelet engraftment and decrease severe acute graft versus host disease without relapse in haploidentical peripheral blood stem cell transplantation

Xiaoning Wang et al. J Int Med Res. 2020 May.

Abstract

Background: Mesenchymal stem cells (MSCs) may be used to treat steroid-refractory graft versus host disease (GVHD). However, the effects of MSCs in haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) have not been confirmed in randomized studies.

Methods: We conducted a randomized clinical study to investigate the effects of pre-infusion (1 × 106 cells/kg) MSCs on hematopoietic recovery, Epstein-Barr and cytomegalovirus infection, GVHD, and relapse in patients undergoing haplo-PBSCT. Fifty patients with acute leukemia or myelodysplastic syndrome were randomly divided into an MSC group administered 1 × 106 MSCs/kg 4 to 6 hours before infusion of peripheral stem cells and a control group without MSCs.

Results: Mean platelet engraftment time was significantly faster in the MSC compared with the control group (12.28 vs 13.29 days). The mean neutrophil engraftment time was comparable in both groups (10.76 ± 2.40 vs. 10.29 ± 1.72 days). Grade II or above acute GVHD was significantly decreased in the MSC compared with the control group (12% vs. 36%). There were no significant differences in relapse rate or overall survival between the groups.

Conclusion: These results suggest that pre-infusion single-dose MSCs promote platelet engraftment and decrease severe acute GVHD without increasing relapse rate.

Keywords: Mesenchymal stem cell; acute leukemia; graft versus host disease; haploidentical peripheral blood stem cell transplantation; myelodysplastic syndrome; platelet engraftment.

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Figures

Figure 1.
Figure 1.
Flowchart of patients. MSC, mesenchymal stem cell.
Figure 2.
Figure 2.
Acute graft versus host disease in the two groups. MSC, mesenchymal stem cell; aGVHD, acute graft versus host disease.
Figure 3.
Figure 3.
Overall (a) and progression-free survival (b) in the two groups. MSC, mesenchymal stem cell.
See this image and copyright information in PMC

References

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