Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Letter to the Editor
  • Published:

Good responses but high TRM in adult patients after MSC therapy for GvHD

Bone Marrow Transplantation volume 52, pages 606–608 (2017)Cite this article

Subjects

Despite many advances in the field of allogeneic hematopoietic stem cell transplantation (alloHSCT) only limited progress has been made in the treatment of steroid-refractory GvHD. Around 40–80% of transplant recipients experience grade II–IV acute GvHD (aGvHD), and a sustained response to first line corticosteroid treatment is achieved only in half of them.1, 2 Grade IV steroid-refractory aGvHD is associated with particularly poor prognosis with a long-term survival of less than 10%.3

We report the outcome of 30 consecutive adult and pediatric patients who were treated for steroid-refractory GvHD with third party bone marrow-derived, platelet-lysate (PL)-expanded mesenchymal stem cells (MSCs) in a prospective single-arm study. Adult patients had undergone allogeneic SCT for a malignant or non-malignant disease at Turku University Hospital or Helsinki University Hospital and pediatric patients at Helsinki Children’s Hospital.

This is a preview of subscription content, access via your institution

Relevant articles

Open Access articles citing this article.

Access options

Buy this article

  • Purchase on Springer Link
  • Instant access to full article PDF
Buy now

Prices may be subject to local taxes which are calculated during checkout

Figure 1

References

  1. Levine JE, Hogan WJ, Harris AC, Litzow MR, Efebera YA, Devine SM et al. Improved accuracy of acute graft-versus-host disease staging among multiple centers. Best Pract Res Clin Haematol 2014; 27: 283–287.

    Article  Google Scholar 

  2. Ferrara JLM, Levine JE, Reddy P, Holler E . Graft-versus-host disease. Lancet 2009; 373: 1550–1561.

    Article  CAS  Google Scholar 

  3. Cahn J-Y, Klein JP, Lee SJ, Milpied NM, Blaise D, Antin JH et al. Prospective evaluation of 2 acute graft-versus-host (GvHD) grading system: a joint Société Française de Greffe de Moëlle et Thérapie Cellulaire (SFGM-TC), Dana Farber Cancer Institute (DFCI) and International Bone Marrow Transplant Registry (IBMTR) prospective study. Blood 2005; 106: 1495–1450.

    Article  CAS  Google Scholar 

  4. Glucksberg H, Storb R, Fefer A, Buckner CD, Neiman PE, Clift RA et al. Clinical manifestations of graft-versus-host disease in human recipients of marrow from HLA-matched sibling donors. Transplantation 1974; 18: 295–304.

    Article  CAS  Google Scholar 

  5. Jagasia M, Greinix H, Arora M, Williams K, Wolff D, Cowen W et al. National Institutes of Health consensus development project on criteria for clinical trials in chronic graft-versus-host disease: I. The 2014 Diagnosis and staging working group report. Biol Blood Marrow Transplant 2015; 21: 389–401.

    Article  Google Scholar 

  6. Laitinen A, Oja S, Kilpinen L, Kaartinen T, Möller J, Laitinen S et al. A robust and reproducible animal serum-free culture method for clinical-grade bone marrow-derived mesenchymal stromal cells. Cytotechnology 2016; 68: 891–906.

    Article  CAS  Google Scholar 

  7. Levine JE, Logan B, Wu J, Alousi AM, Ho V, Bolanos-Meade J et al. Graft-versus-host disease treatment: predictors of survival. Biol Blood Marrow Transplant 2010; 16: 1693–1699.

    Article  Google Scholar 

  8. Ringden O, Erkers T, Nava S, Uzunel M, Iwarsson E, Conrad R et al. Fetal membrane cells for treatment of steroid-refractory acute graft-versus-host disease. Stem Cells 2013; 31: 592–601.

    Article  CAS  Google Scholar 

  9. Le Blanc K, Frassoni F, Ball L, Locatelli F, Roelofs H, Lewis I et al. Mesenchymal stem cells for treatment of steroid-resistant, severe, acute graft-versus-host disease: a phase II study. Lancet 2008; 371: 1579–1586.

    Article  CAS  Google Scholar 

  10. Ball LM, Bernando ME, Roelofs H, van Tol MJD, Contoli B, Zwaginga JJ et al. Multiple infusions of mesenchymal stromal cells induce sustained remission in children with steroid-refractory, grade III–IV acute graft-versus-host disease. Br J Haematol 2013; 163: 501–509.

    Article  CAS  Google Scholar 

  11. Von Dalowski F, Kramer M, Wermke M, Wehner R, Röllig C, Alakel N et al. Mesenchymal stromal cells for treatment of acute steroid-refractory GvHD: clinical responses and long-term outcome. Stem Cells 2016; 34: 357–366.

    Article  CAS  Google Scholar 

  12. Hashmi S, Ahmed M, Murad MH, Litzow MR, Adams RH, Ball LM et al. Survival after mesenchymal stromal cell therapy in steroid-refractory acute graft-versus-host disease: systematic review and meta-analysis. Lancet Haematol 2016; 3: e45–e52.

    Article  Google Scholar 

  13. Chen X, Wang C, Yin J, Xu J, Wei J, Xhang Y . Efficacy of mesenchymal stem cell therapy for steroid-refractory acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation: a systematic review and meta-analysis. PLoS One 2015; 10: e0136991.

    Article  Google Scholar 

  14. Martin P, Rizzo JD, Wingard JR, Ballen K, Curtin PT, Cutler C et al. First- and second-line systemic treatment of acute graft-versus-host disease: recommendations of the American Society of Blood and Marrow Transplantation. Biol Blood Marrow Transplant 2012; 18: 1150–1163.

    Article  Google Scholar 

Download references

Acknowledgements

We sincerely thank data manager Jaana Vettenranta at Helsinki Children’s Hospital for her help in data collection and the personnel at the Advanced Cell Therapy Centre at the FRCBS, Helsinki Finland.

Author information

Authors and Affiliations

  1. Department of Clinical Hematology and Stem Cell Transplantation, Turku University Hospital and University of Turku, Turku, Finland

    U Salmenniemi, M Itälä-Remes & M Putkonen

  2. Advanced Cell Therapy Centre, Finnish Red Cross Blood Service, Helsinki, Finland

    J Nystedt & M Korhonen

  3. Comprehensive Cancer Center, Stem Cell Transplantation Unit, Helsinki University Hospital, Helsinki, Finland

    R Niittyvuopio

  4. Helsinki University Children’s Hospital and University of Helsinki, Helsinki, Finland

    K Vettenranta

Authors
  1. U Salmenniemi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. M Itälä-Remes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J Nystedt
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M Putkonen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. R Niittyvuopio
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. K Vettenranta
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. M Korhonen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to U Salmenniemi.

Ethics declarations

Competing interests

The authors declare no conflict of interest.

Additional information

Supplementary Information accompanies this paper on Bone Marrow Transplantation website

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Salmenniemi, U., Itälä-Remes, M., Nystedt, J. et al. Good responses but high TRM in adult patients after MSC therapy for GvHD. Bone Marrow Transplant 52, 606–608 (2017). https://doi.org/10.1038/bmt.2016.317

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/bmt.2016.317

This article is cited by

Search

Advanced search

Quick links