Mesenchymal Stromal Cells as First-Line Treatment of Graft Failure After Hematopoietic Stem Cell Transplantation

Abstract We retrospectively investigated the incidence and outcomes of allogeneic hematopoietic stem cell transplantation (allo-HSCT) recipients with autoimmune hemolytic anemia (AIHA). A total of 1,377 patients enrolled in this study, and the 3-year cumulative incidence of AIHA was 2.2±0.4%. Twenty-five patients with AIHA received treatment, including 15 patients who received corticosteroids combined with Cyclosporine A(CsA )and 10 who received corticosteroids monotherapy. After four weeks of treatment, the patients treated with corticosteroids combined with CsA had a higher complete response rate than those with corticosteroids monotherapy (66.7% vs. 11.1%; P=0.013). One patient (6.7%) experienced AIHA relapse in the combined group, and 5 (50.0%) relapsed in the monotherapy group (P=0.023). The 5-year cumulative incidence of malignant disease relapse was 5.5±5.1% and 27.4±1.4% (P=0.032), the OS was 86.3 ± 7.4% and 65.2 ± 1.6% (P=0.046), and the transplant-related mortality (TRM) post-transplantation was 9.3±6.4% and 22.8±1.6% (P=0.140), respectively, for patients with AIHA and those without AIHA. Our results indicate that corticosteroids combined with CsA is superior to corticosteroids as first-line treatment for AIHA, and AIHA does not contribute to increased primary disease relapse and TRM. Disclosures No relevant conflicts of interest to declare.

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Allogeneic hematopoietic stem cell transplantation as the first-line treatment option in a patient with severe aplastic anemia without a matched related donor: A case report

Oncology Letters ◽

10.3892/ol.2014.2341 ◽

2014 ◽

Vol 8 (4) ◽

pp. 1831-1833

Author(s):

SHUN-NENG HSU ◽

JIA-HONG CHEN ◽

WOEI-YAU KAO

Keyword(s):

Stem Cell ◽

Case Report ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Aplastic Anemia ◽

Line Treatment ◽

First Line ◽

Hematopoietic Stem ◽

Related Donor ◽

First Line Treatment

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Recovery of Donor Hematopoiesis after Graft Failure and Second Hematopoietic Stem Cell Transplantation with Intraosseous Administration of Mesenchymal Stromal Cells

Stem Cells International ◽

10.1155/2018/6495018 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Nataliya Petinati ◽

Nina Drize ◽

Natalia Sats ◽

Natalya Risinskaya ◽

Andrey Sudarikov ◽

...

Keyword(s):

Stem Cells ◽

Bone Marrow ◽

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Stromal Cells ◽

Graft Failure ◽

Hematopoietic Stem

Multipotent mesenchymal stromal cells (MSCs) participate in the formation of bone marrow niches for hematopoietic stem cells. Donor MSCs can serve as a source of recovery for niches in patients with graft failure (GF) after allogeneic bone marrow (BM) transplantation. Since only few MSCs reach the BM after intravenous injection, MSCs were implanted into the iliac spine. For 8 patients with GF after allo-BMT, another hematopoietic stem cell transplantation with simultaneous implantation of MSCs from their respective donors into cancellous bone was performed. BM was aspirated from the iliac crest of these patients at 1-2, 4-5, and 9 months after the intraosseous injection of donor MSCs. Patients’ MSCs were cultivated, and chimerism was determined. In 6 out of 8 patients, donor hematopoiesis was restored. Donor cells (9.4 ± 3.3%) were detected among MSCs. Thus, implanted MSCs remain localized at the site of administration and do not lose the ability to proliferate. These results suggest that MSCs could participate in the restoration of niches for donor hematopoietic cells or have an immunomodulatory effect, preventing repeated rejection of the graft. Perhaps, intraosseous implantation of MSCs contributes to the success of the second transplantation of hematopoietic stem cells and patient survival.

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Alterations in the Cellular Immune Compartment of Patients Treated with Third-Party Mesenchymal Stromal Cells Following Allogeneic Hematopoietic Stem Cell Transplantation

Stem Cells ◽

10.1002/stem.1386 ◽

2013 ◽

Vol 31 (8) ◽

pp. 1715-1725 ◽

Cited By ~ 52

Author(s):

Regina Jitschin ◽

Dimitrios Mougiakakos ◽

Lena Von Bahr ◽

Simon Völkl ◽

Guido Moll ◽

...

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Mesenchymal Stromal Cells ◽

Stromal Cells ◽

Third Party ◽

Hematopoietic Stem ◽

Cellular Immune

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Telomere shortening in hematopoietic stem cell transplantation: A potential mechanism for late graft failure?

Biology of Blood and Marrow Transplantation ◽

10.1053/bbmt.2002.v8.abbmt080597 ◽

2002 ◽

Vol 8 (11) ◽

pp. 597-600 ◽

Cited By ~ 41

Author(s):

Norihiro Awaya ◽

Gabriela M Baerlocher ◽

Thomas J Manley ◽

Jean E Sanders ◽

Marco Mielcarek ◽

...

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Graft Failure ◽

Potential Mechanism ◽

Telomere Shortening ◽

Hematopoietic Stem

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SECOND ALLOGENEIC HEMATOPOIETIC STEM CELL TRANSPLANTATION IN PATIENTS WITH HEMATOLOGICAL MALIGNANCIES

Hematology and Transfusiology ◽

10.35754/0234-5730-2019-64-1-35-48 ◽

2019 ◽

Vol 64 (1) ◽

pp. 35-48

Author(s):

L. A. Kuzmina ◽

Z. V. Konova ◽

E. N. Parovichnikova ◽

M. Y. Drokov ◽

V. A. Vasilyeva ◽

...

Keyword(s):

Stem Cell ◽

Hematopoietic Stem Cell Transplantation ◽

Stem Cell Transplantation ◽

Disease Progression ◽

Cell Transplantation ◽

Hematopoietic Stem Cell ◽

Graft Failure ◽

Hematological Malignancies ◽

Lymphoblastic Leukemia ◽

Hematopoietic Stem

Background.Allogeneic hematopoietic stem cell transplantation (allo-HSCT) is a standard treatment for many patients with hematological malignancies. Complications of allo-HSCT are frequently associated either with a relapse of the underlying disease or a graft failure. Second transplantation can be offered to selected patients and is seen as the only curative option. In this paper, we report the experience of managing 24 such patients, all of whom underwent a second allo-HSCT.Patients and methods.The research involved 24 patients (12 males/12 females) suffering from acute myeloid leukemia (AML, n = 14), acute lymphoblastic leukemia (ALL, n = 4), myeloproliferative disease (MPD, n = 3) and myelodysplastic syndrome (MDS, n = 3). The patients’ age ranged from 18 to 56 years, with the median age being 32 years. All the patients underwent a second allo-HSCT due to the disease relapse (n = 11) or graft failure (n = 13). 12 patients underwent a second allo-HSCT within the period of less than 6 months after the first allo-HSCT.Results.Following the second allo-HSCT, engraftment occurred in 18/24 (75 %) patients, while 3 patients demonstrated graft failure and 3 — disease progression. Out of 18 patients having engrafted, 9 (50%) died during the first 100 days after allo-HSCT as a result of severe infections or visceral toxicity. 3 more lethal outcomes were recorded in later periods due to the disease progression. The overall mortality rate after the second allo-HSCT equalled 61.5 %. The median overall survival (OS) and disease-free survival (DFS) rates were 13.5 months and 10.59 months, respectively. Three-year OS and DFS were 38.5 % and 27.6 % respectively. Significant differences in terms of OS were detected for patients with a longer interval (>6 months) between the first and second allo-HSCT. The change of a donor was not associated with a better clinical outcome.

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