Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Jan-Dec:34:9636897251359786.
doi: 10.1177/09636897251359786. Epub 2025 Jul 25.

Triple stem cell infusion alleviated graft-versus-host disease and improves outcomes in unmanipulated haploidentical hematopoietic stem cell transplantation

Fang Hua  1   2 , Shan Zhang  1 , Xiaomei Zhang  1 , Yan Deng  1 , Ying Han  1 , Sihan Lai  1 , Ying He  1 , Lei Ma  1 , Xupai Zhang  1 , Dan Chen  1 , Yi Su  1 , Jian Xiao  2 , Ling Zhang  1 , Hui Yang  1 , Rong Huang  1 , Haiyan Hu  3 , Mingli Chen  3 , Guangcui He  1 , Hao Yao  1 , Hai Yi  1
Affiliations

Triple stem cell infusion alleviated graft-versus-host disease and improves outcomes in unmanipulated haploidentical hematopoietic stem cell transplantation

Fang Hua et al. Cell Transplant. 2025 Jan-Dec.

Abstract

Haploidentical hematopoietic stem cell transplantation (Haplo-HSCT) provides cure opportunity for patients requiring prompt allogeneic HSCT but failing to identify well-matched donor, but its outcomes are potentially impaired by increased transplant-related mortality (TRM). We performed haplo-HSCT using granulocyte colony-stimulating factor (G-CSF)-primed peripheral blood stem cells (PBSCs), umbilical cord mesenchymal stem cells (UC-MSCs) and third-party unrelated umbilical cord blood (UCB) stem cells. Modified "Beijing protocol" were performed in this study. All of the patients were transplanted by Busulfan or TBI-based regimen. Anti-thymocyte globulin were used to T-cell depletion in vivo. Cyclosporine, mycophenolate mofetil, and short course methotrexate were used to prevent graft-versus-host disease (GVHD). One hundred and sixty-five patients with hematological disorders undergoing haplo-HSCT from Jan 2021 to Nov 2023 were included in this study. The median time of neutrophil engraftment were 12 days (range: 9-25 days), and the median time of platelet engraftment were 13 days (range: 6-50 days). Full haploidentical donor chimerism were obtained within 30 days. No evidence of UCB chimerism was found. Twenty-five patients developed acute GVHD. The incidence of grade II-IV and grade III-IV acute GVHD was 12.73% and 6.67%, respectively. Twenty-eight patients developed chronic GVHD, 10 were limited (6.06%) and 18 were extensive (10.91%). The TRM is total of 26 deaths (15.8%) and the cumulative incidence of relapse (CIR) is total of 17 deaths (11.8%) occurred as of the statistical period. The 2 years overall survival (OS) rate is 72.96%. The median overall survival rate was not reached. Haplo-HSCT performed by PBSCs, UC-MSCs and UCB "triple-infusion" achieved excellent outcomes, and need to explored in a larger cohort.

Keywords: graft-versus-host disease (GVHD); haploidentical hematopoietic allogeneic stem cell transplantation (Haplo-HSCT); mesenchymal stem cells (MSCs); peripheral blood stem cells (PBSCs); umbilical cord blood (UCB).

PubMed Disclaimer

Conflict of interest statement

Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Graphical abstract
Graphical abstract
### Description 1 (a single line)Time to neutrophil engraftment (days). (b) Probability of overall survival (%). (c) Incidence of aGVHD. (d) Time to platelet engraftment (days). (e) Probability of overall survival of leukemia. (f) Incidence of cGVHD.### Description 2 (more words)
Figure 1.
(a) Time to neutrophil engraftment (days). (b) Probability of overall survival (%). (c) Incidence of aGVHD. (d) Time to platelet engraftment (days). (e) Probability of overall survival of leukemia. (f) Incidence of cGVHD.
See this image and copyright information in PMC

References

    1. Willem C, Guillaume T, Makanga DR, Legrand N, Cesbron A, Gagne K, Peterlin P, Garnier A, Bourgeois LA, Bene MC, Chevallier P, et al. Ptcy + ATG Vs Ptcy alone as Gvhd prophylaxis for peripheral blood stem cells haplo-transplants: comparison of NK and T cell effector reconstitution. Blood. 2019;134(Suppl 1):1999.
    1. Burnham AJ, Daley-Bauer LP, Horwitz EM, Mesenchymal stromal cells in hematopoietic cell transplantation. Blood Adv. 2020;4(22):5877–87. - PMC - PubMed
    1. Zhou B, Chen J, Liu T, Ye Y, Zhang Y, Ding Y, Liu H, Zhu M, Ma X, Li X, Zhao L, et al. Haploidentical hematopoietic cell transplantation with or without an unrelated cord blood unit for adult acute myeloid leukemia: a multicenter, randomized, open-label, phase 3 trial. Signal Transduct Target Ther. 2024;9(1):108. - PMC - PubMed
    1. Luo C, Li X, Yan B, Qin D, Tian X, Wang P, Chen R, Zhang P, Gong Q, Peng X, Li X, et al. Quadruple stem cells transplantation of haploidentical bone marrow and PBSCs supporting by third-party umbilical cord blood and MSCs achieved excellent outcomes. Ann Hematol. 2023;102(11):3285–87. - PubMed
    1. Huang F, Zeng X, Fan Z, Xu N, Yu S, Xuan L, Liu H, Jin H, Lin R, Shi P, Zhao K, et al. Haplo-peripheral blood stem cell plus cord blood grafts for hematologic malignancies might lead to lower relapse compared with haplo-peripheral blood stem cell plus bone marrow grafts. Transplant Cell Ther. 2022;28(12):849e1–8849. - PubMed

LinkOut - more resources