Ringdén O, Uzunel M, Sundberg B, Lönnies L, Nava S, Gustafsson J, Henningsohn L, Le Blanc K
Centre for Allogeneic Stem Cell Transplantation, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden.
Leukemia. 2007 Nov;21(11):2271-6. doi: 10.1038/sj.leu.2404833. Epub 2007 Jul 5.
Mesenchymal stem cells (MSC) possess anti-inflammatory properties and participate in tissue repair. We used MSC to heal therapy-induced tissue toxicity. Ten consecutive patients, treated with MSC due to tissue toxicity following allogeneic hematopoietic stem cell transplantation, (ASCT) were included. Their median age was 48 (13-64) years. Seven had hemorrhagic cystitis grades 2-5, two had pneumomediastinum and one had perforated colon and peritonitis. MSC donors were mainly third-party, HLA-mismatched (n=11), HLA-haploidentical (n=3) and, in two cases, the HLA-identical ASCT sibling donors. MSC were given intravenously, the median cell dose was 1.0 (range 0.7-2)x10(6)/kg. In five patients, the severe hemorrhagic cystitis cleared after MSC infusion. Gross hematuria disappeared after median 3 (1-14) days. Two patients had reduced transfusion requirements after MSC infusion, but died of multiorgan failure. In one of them, MSC donor DNA was demonstrated in the urinary bladder. In two patients, pneumomediastinum disappeared after MSC infusions. A patient with steroid-resistant graft-versus-host disease of the gut experienced perforated diverticulitis and peritonitis that was reversed twice by MSC. MSC is a novel treatment for therapy-induced tissue toxicity.
间充质干细胞（MSC）具有抗炎特性并参与组织修复。我们使用MSC来治疗治疗引起的组织毒性。纳入了10例因异基因造血干细胞移植（ASCT）后组织毒性而接受MSC治疗的连续患者。他们的中位年龄为48（13 - 64）岁。7例患有2 - 5级出血性膀胱炎，2例患有纵隔气肿，1例患有结肠穿孔和腹膜炎。MSC供体主要是第三方，HLA不匹配（n = 11），HLA单倍体相同（n = 3），在两例中，是HLA相同的ASCT同胞供体。MSC通过静脉注射给药，中位细胞剂量为1.0（范围0.7 - 2）×10⁶/kg。5例患者在输注MSC后严重出血性膀胱炎得以缓解。肉眼血尿在中位3（1 - 14）天后消失。2例患者在输注MSC后输血需求减少，但死于多器官功能衰竭。其中1例患者的膀胱中检测到了MSC供体DNA。2例患者在输注MSC后纵隔气肿消失。1例患有类固醇难治性肠道移植物抗宿主病的患者发生了穿孔性憩室炎和腹膜炎，经MSC治疗两次后病情得到逆转。MSC是治疗治疗引起的组织毒性的一种新方法。
