Efficacy and Safety of Human Umbilical Cord Derived Mesenchymal Stem Cell Therapy in Children with Severe Aplastic Anemia Following Allogeneic Hematopoietic Stem Cell Transplantation: A Retrospective Case Series of 37 Patients

被引:15
|
作者
Si, Yingjian [1 ]
Yang, Kai [2 ]
Qin, Maoquan [1 ]
Zhang, Chuancang [1 ]
Du, Zhenlan [1 ]
Zhang, Xiaomei [1 ]
Liu, Yuhuan [1 ]
Yue, Yan [1 ]
Feng, Zhichun [1 ]
机构
[1] Gen Hosp Beijing Mil Command, Bayi Childrens Hosp, Dept Childrens Hematol & Oncol, Beijing 100700, Peoples R China
[2] Beijing Mil Gen Hosp, Dept Hematol, Beijing, Peoples R China
基金
中国博士后科学基金;
关键词
allogeneic hematopoietic stem cell transplantation; human umbilical cord derived mesenchymal stem cell; severe aplastic anemia; BONE-MARROW-TRANSPLANTATION; VERSUS-HOST-DISEASE; ANTI-THYMOCYTE GLOBULIN; STROMAL CELLS; CONDITIONING REGIMENS; ALTERNATIVE DONOR; UNRELATED DONOR; GRAFT; FLUDARABINE; CYCLOPHOSPHAMIDE;
D O I
10.3109/08880018.2013.867556
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
The treatment of pediatric severe aplastic anemia (SAA) with allogeneic hematopoietic stem cell transplantation (allo-HSCT), presents major challenges including the risks of graft failure, septic complications, and graft-versus-host disease (GVHD). Additive infusions of human umbilical cord derived mesenchymal stem cell (hUC-MSC) may be administered to improve patient survival. We retrospectively examined 37 pediatric patients with SAA who received allo-HSCT and subsequent infusions of hUC-MSC suspension at a dose of 1.0x10(6)/kg. The times and doses of hUC-MSC infusions were increased in patients with severe GVHD. All patients received hUC-MSC infusions. The median time to post-transplantation neutrophil count of greater than 0.5x10(9)/L was 14 days (range, 11-20 days) and time to post-transplantation platelet count of greater than 20x10(9)/L was 19 days (14-29 days). The overall frequency of acute GVHD (aGVHD) was 45.9% (17/37). These aGVHD episodes occurred at a median time of post-transplantation 47 days (15-83 days). The frequency of chronic GVHD (cGVHD) was 18.9% (7/37); cGVHD developed from aGVHD in 10.8% (4/37) of patients. The GVHD-associated mortality rate was 18.9% (7/37) and aGVHD-specific mortality rate was 8.1% (3/37). The median overall survival time was 35 months (9-67 months) and the three-year overall survival rate was 74.2% (28/37). Seven patients died of GVHD, one patient died of a severe invasive fungal infection, and one patient died of renal failure. In conclusion, post-transplantation hUC-MSC infusions seemed to be safely infused in children with SAA who have previously received allo-HSCT.
引用
收藏
页码:39 / 49
页数:11
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