Single intra-arterial injection of mesenchymal stromal cells for treatment of steroid-refractory acute graft-versus-host disease: a pilot study |
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| Authors: | Nobuyoshi Arima Fumiaki Nakamura Akiko Fukunaga Hirokazu Hirata Hiroko Machida Shigene Kouno Hajime Ohgushi |
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| Affiliation: | 1. Departments of Hematology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan;2. Departments of Radiology, The Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan;3. National Institute of Advanced Industrial Science and Technology, Osaka, Japan;1. Department of Haematology, Imperial College London, Hammersmith Campus, London, United Kingdom;2. Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Centre, Houston, TX;3. University of Wuerzburg, Wuerzburg, Germany;4. Division of Brain Sciences, Imperial College London, United Kingdom;5. Baylor College of Medicine. Houston, TX;6. University College, London, United Kingdom;1. Department of Hematology, Air Force General Hospital, PLA. Beijing, China;2. Department of Experimental Hematology, Beijing Institute of Radiation Medicine, Beijing, China;1. Department of Hematology, Tianjin Medical University Cancer Hospital and Institute, Tianjin, China;2. Department of Hematology, First Affiliated Hospital of General Hospital of the Chinese People''s Liberation Army, Beijing, China |
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| Abstract: | Background aimsCell therapy with mesenchymal stromal cells (MSC) has been reported recently as a promising treatment for severe acute graft-versus-host disease (GvHD).MethodsWe designed a pilot study to treat severe hepatic or gut GvHD using MSC derived from only the donor and cultured without bovine serum. Because the number of cultured MSC is smaller using this method, we planned to treat patients by intra-arterial regional administration directly to the target organs.ResultsThree patients were enrolled, and the MSC could be expanded using donor serum. There were no obvious side-effects immediately after arterial injection. The maximum response was partial in one of three patients and did not continue for more than 2 months. Idiopathic pneumonia syndrome developed in two of the three patients.ConclusionsA single local arterial MSC injection was unable to save these patients' lives and so might not be more effective than multiple systemic intravenous MSC injection. Further clinical research and additional strategies are required to develop appropriate methods for using MSC to achieve extended remission of GvHD. |
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