Safety and efficacy of mesenchymal stromal cell therapy for multi-drug-resistant acute and late-acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation

Basit Öğe Kaydı
dc.authoridKaynar, Leylagul/0000-0002-2035-9462
dc.authoridCelik, Serhat/0000-0002-1052-9800
dc.authoridGONEN, ZEYNEP BURCIN/0000-0003-2725-9330
dc.authoridKeklik, Muzaffer/0000-0002-6426-5249
dc.authoridKeklik, Ertugrul/0000-0003-4915-8012
dc.contributor.authorKeklik, Muzaffer
dc.contributor.authorDeveci, Burak
dc.contributor.authorCelik, Serhat
dc.contributor.authorDeniz, Kemal
dc.contributor.authorGonen, Zeynep Burcin
dc.contributor.authorZararsiz, Gokmen
dc.contributor.authorSaba, Rabin
dc.date.accessioned2025-01-21T16:44:18Z
dc.date.available2025-01-21T16:44:18Z
dc.date.issued2023
dc.departmentKırıkkale Üniversitesi
dc.description.abstractGraft versus host disease (GvHD) remains a significant risk for mortality and morbidity following allogeneic hematopoietic stem cell transplantation (HSCT). A growing literature supports successful applications of mesenchymal stromal cells (MSCs) for the treatment of steroid-refractory acute GvHD (aGvHD). However, there is limited knowledge about the effects of MSC treatment on late-acute GvHD (late aGvHD). In this article, we present our multicenter study on the safety and efficacy of MSC therapy for patients with steroid-refractory late aGvHD in comparison to those with aGvHD. The outcome measures include non-relapse mortality (NRM) and survival probability over a 2-year follow-up. The study includes a total of 76 patients with grades III-IV aGvHD (n = 46) or late aGvHD (n = 30), who had been treated with at least two lines of steroid-containing immunosuppressive therapy. Patients received weekly adipose or umbilical cord-derived MSC infusions at a dose of median 1.55 (ranging from 0.84 to 2.56) x 10(6)/kg in the aGvHD group, and 1.64 (ranging from 0.85 to 2.58) x 10(6)/kg in the late aGvHD group. This was an add-on treatment to ongoing conventional pharmaceutical management. In the aGvHD group, 23 patients received one or two infusions, 20 patients had 3-4, and three had >= 5. Likewise, in the late aGvHD group, 20 patients received one or two infusions, nine patients had 3-4, and one had >= 5. MSC was safe without acute or late adverse effects in 76 patients receiving over 190 infusions. In aGvHD group, 10.9% of the patients had a complete response (CR), 23.9% had a partial response (PR), and 65.2% had no response (NR). On the other hand, in the late aGvHD group, 23.3% of the patients had CR, 36.7% had PR, and the remaining 40% had NR. These findings were statistically significant (p = 0.031). Also, at the 2-year follow-up, the cumulative incidence of NRM was significantly lower in patients with late aGvHD than in patients with aGvHD at 40% (95% CI, 25-62%) versus 71% (95% CI, 59-86%), respectively (p = 0.032). In addition, the probability of survival at 2 years was significantly higher in patients with late aGvHD than in the aGvHD group at 59% (95% CI, 37-74%) versus 28% (95% CI, 13-40%), respectively (p = 0.002). To our knowledge, our study is the first to compare the safety and efficacy of MSC infusion(s) for the treatment of steroid-resistant late aGVHD and aGVHD. There were no infusion-related adverse effects in either group. The response rate to MSC therapy was significantly higher in the late aGvHD group than in the aGvHD group. In addition, at the 2-year follow-up, the survival and NRM rates were more favorable in patients with late aGVHD than in those with aGVHD. Thus, the results are encouraging and warrant further studies to optimize MSC-based treatment for late aGVHD.
dc.identifier.doi10.1007/s00277-023-05216-3
dc.identifier.endpage1547
dc.identifier.issn0939-5555
dc.identifier.issn1432-0584
dc.identifier.issue6
dc.identifier.pmid37067556
dc.identifier.scopus2-s2.0-85153111378
dc.identifier.scopusqualityQ2
dc.identifier.startpage1537
dc.identifier.urihttps://doi.org/10.1007/s00277-023-05216-3
dc.identifier.urihttps://hdl.handle.net/20.500.12587/25419
dc.identifier.volume102
dc.identifier.wosWOS:000970703200001
dc.identifier.wosqualityQ2
dc.indekslendigikaynakWeb of Science
dc.indekslendigikaynakScopus
dc.indekslendigikaynakPubMed
dc.language.isoen
dc.publisherSpringer
dc.relation.ispartofAnnals of Hematology
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı
dc.rightsinfo:eu-repo/semantics/closedAccess
dc.snmzKA_20241229
dc.subjectAllogeneic hematopoietic stem cell transplantation; Graft-versus-host disease; Mesenchymal stromal cells
dc.titleSafety and efficacy of mesenchymal stromal cell therapy for multi-drug-resistant acute and late-acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation
dc.typeArticle

Dosyalar

Koleksiyon

WOS İndeksli Yayınlar Koleksiyonu
PubMed İndeksli Yayınlar Koleksiyonu
Scopus İndeksli Yayınlar Koleksiyonu