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Third‐party mesenchymal stromal cell infusion is associated with a decrease in thrombotic microangiopathy symptoms observed post‐hematopoietic stem cell transplantation
Author(s) -
Ansari Marc,
Strunk Dirk,
Schallmoser Katharina,
Delcò Cristina,
Rougemont AnneLaure,
Moll Solange,
Villard Jean,
GumyPause Fabienne,
Chalandon Yves,
Parvex Paloma,
Passweg Jakob,
Ozsahin Hulya,
Kindler Vincent
Publication year - 2012
Publication title -
pediatric transplantation
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.457
H-Index - 69
eISSN - 1399-3046
pISSN - 1397-3142
DOI - 10.1111/j.1399-3046.2011.01621.x
Subject(s) - medicine , thrombotic microangiopathy , transplantation , intensive care unit , surgery , hematopoietic stem cell transplantation , mesenchymal stem cell , microangiopathy , stem cell , aplastic anemia , gastroenterology , disease , pathology , bone marrow , diabetes mellitus , endocrinology , biology , genetics
Ansari M, Strunk D, Schallmoser K, Delcò C, Rougemont A‐L, Moll S, Villard J, Gumy‐Pause F, Chalandon Y, Parvex P, Passweg J, Ozsahin H, Kindler V. Third‐party mesenchymal stromal cell infusion is associated with a decrease in thrombotic microangiopathy symptoms observed post‐hematopoietic stem cell transplantation. Pediatr Transplantation 2012: 16: 131–136. © 2011 John Wiley & Sons A/S. Abstract: TA‐TMA is a pathology that occurs after allogenic HSC transplantation with an incidence of 4–13%, and represents one of the most severe vascular damage related with this therapy. We report here the case of a nine‐yr‐old girl suffering from a severe refractory aplastic anemia who received an unrelated, 9/10 HLA‐matched HSC. Soon after transplantation, the patient developed a graft‐versus‐host disease (GvHD), a TA‐TMA, and renal insufficiency. These pathologies remained refractory to the various treatments undertaken and required several hospitalizations in the intensive care unit. On day 106 post‐HSC transfusion, after several episodes of intensive care, the patient was infused with mismatched, third‐party MSCs. Schizocyte levels rapidly decreased after MSC infusion, and two wk later, most biological parameters returned to normal. Erythrocyte and thrombocyte transfusions were discontinued, and the patient remained stable for 10 wk. Thereafter, TA‐TMA symptoms, viral reactivation, pleural and cardiac effusions reappeared and lead to the death of the patient. Our observations suggest that allogenic MSC infusion may decrease the symptoms of TA‐TMA, but further investigation is required to determine how and when MSC should be infused to develop a long‐lasting protective effect.