Open AccessClinical Use of Mesenchymal Stromal Cells in the Treatment of Acute Graft-versus-Host Disease
Author(s) -
Sümeyye Elgaz,
Zyrafete Kuçi,
Selim Kuçi,
Halvard Bönig,
Peter Bader
Publication year - 2019
Publication title -
transfusion medicine and hemotherapy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.971
H-Index - 39
eISSN - 1660-3818
pISSN - 1660-3796
DOI - 10.1159/000496809
Subject(s) - mesenchymal stem cell , medicine , clinical trial , graft versus host disease , transplantation , disease , refractory (planetary science) , cell therapy , in vivo , immunology , intensive care medicine , stem cell , pathology , biology , genetics , microbiology and biotechnology , astrobiology
Acute graft-versus-host disease (aGvHD) continues to impact morbidity and mortality after allogeneic stem cell transplantation (allo-SCT). First-line therapy for aGvHD still remains the use of high-dose corticosteroids. Unfortunately, 40-60% of patients with aGvHD exhibit steroid resistance, which is associated with a very poor prognosis. As no effective second-line therapy existed, in recent decades various treatment options were considered for the treatment of therapy-refractory GvHD. Based on their in vitro immunomodulatory properties, the use of mesenchymal stromal cells (MSCs) in the treatment of aGvHD has been introduced. However, most of the clinical data are generated from uncontrolled trials and case series, showing clinical responses to MSCs. Clinical results are more consistent in children despite the use of MSC preparations of various provenance and manufacturing protocols. While these data support the therapeutic principle, the great variability of outcomes strongly suggests that not all MSC preparations are equal and that the specific manufacturing protocols influence therapeutic success in vivo.