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Additional infusions of mesenchymal stem cells improve response rate in multidrug-resistant GvHD patients

Bone Marrow Transplantation volume 52, pages 783–785 (2017)Cite this article

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GvHD is one of the main limitations to the success of allogeneic hematopoietic stem cell transplantation (HSCT) and has a substantial impact on the quality of life and survival of patients. Its incidence varies from 30 to 80% and depends on several factors such as prophylaxis method, donor/recipient matching, intensity of the conditioning regimen and composition of the graft.1 In GvHD, initial treatment relies on corticosteroids, which produce sustained responses in 50–80% of patients depending on the severity.2, 3 Currently, many drugs are used in patients refractory to steroids, but the majority of these agents are insufficient. In the last few years, studies have been published reporting successful use of mesenchymal stem cells (MSCs) in the treatment of immune-based diseases such as GvHD.4, 5 MSCs have been used in GvHD with a variety of cell doses and infusions with conflicting results due to differences in type and severity of the disease. In this study, we investigated the efficacy of additional infusions of MSCs in patients with partial response (PR) to induction therapy with MSCs.

This study was conducted on 22 patients with refractory GvHD (7 females, 15 males) at the Erciyes Transplantation Center in Kayseri, Turkey between March 2013 and August 2015. Patients with acute or chronic GvHD, grade II–IV, resistant to several lines of therapy were eligible for the study. Steroid resistance was defined according to the current literature.6 All patients received at least two lines of steroid-containing GvHD treatment before MSC therapy. Treatment was continued during MSC therapy. Steroids were gradually stopped before initiation with MSC therapy. In accordance with the current literature MSCs were given in combination with preexisting GvHD treatments.7, 8 The study was approved by the Ethics Committee of Erciyes University and National Stem Cell Council of the Ministry of Health.

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Acknowledgements

The authors thank all personnel from the Bone Marrow Transplantation Department of Erciyes University and we also thank members of the GEN-KOK Good Manufacturing Practice (GMP) facility for their technical support.

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Authors and Affiliations

  1. Erciyes University Transplantation Center, Kayseri, Turkey

    M Cetin, A Unal, N L Tiren-Verbeet & L Kaynar

  2. Department of Hematology, Kayseri Education and Research Hospital, Kayseri, Turkey

    G Akyol & M Keklik

  3. Genome and Stem Cell Center, Erciyes University, Kayseri, Turkey

    Z B Gonen

  4. Department of Statistics, Faculty of Medicine, Erciyes University, Kayseri, Turkey

    G Zararsiz

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  1. M Cetin
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  2. G Akyol
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  6. A Unal
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  7. N L Tiren-Verbeet
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  8. L Kaynar
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Correspondence to M Cetin.

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Cetin, M., Akyol, G., Gonen, Z. et al. Additional infusions of mesenchymal stem cells improve response rate in multidrug-resistant GvHD patients. Bone Marrow Transplant 52, 783–785 (2017). https://doi.org/10.1038/bmt.2017.1

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