Department of Pediatrics, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
Bone Marrow Transplant. 2013 Aug;48(8):1040-5. doi: 10.1038/bmt.2013.7. Epub 2013 Feb 11.
Success of umbilical cord blood transplantation (UCBT) has been limited by a high rate of graft failure and delayed hematological recovery. It has been postulated that MSCs have hematopoiesis-supportive properties. Therefore, to overcome the limitation of UCBT, third-party UCB-derived MSCs were co-transplanted in recipients receiving unrelated UCBT. Seven patients received UCB and third-party UCB-MSCs. Hematopoietic recovery and transplantation outcomes were compared with historic controls. There was no acute toxicity associated with the infusion of MSCs. The median day to neutrophil engraftment was 19 days in patients, as compared with 24 days in controls (P=0.03). The median day of platelet engraftment was 47 days and 57 days in patients and controls, respectively (P=0.26). In addition, there was no engraftment failure in the MSC group. The incidence of acute and chronic GVHD was comparable between the two groups. However, veno-occlusive disease and TRM did not occur in the MSC group. Third-party UCB-MSCs infusion was safe and feasible. MSCs may also enhance the engraftment of UCBT and prevent rejection. In addition, MSCs may have a role in decreasing TRM. Randomized, controlled trials are required to confirm these results and longer follow-up will determine the effects of MSCs on the risk of relapse.
脐带血移植（UCBT）的成功受到移植物失败率高和造血恢复延迟的限制。据推测，间充质干细胞具有支持造血的特性。因此，为了克服 UCBT 的局限性，在接受无关 UCBT 的受者中共同移植第三方 UCB 来源的 MSC。7 名患者接受了 UCB 和第三方 UCB-MSC。比较了造血恢复和移植结果与历史对照。输注 MSC 无急性毒性。与对照组相比，患者中性粒细胞植入的中位时间为 19 天（P=0.03）。患者和对照组血小板植入的中位时间分别为 47 天和 57 天（P=0.26）。此外，MSC 组没有植入失败。两组急性和慢性 GVHD 的发生率相当。然而，MSC 组没有发生静脉阻塞性疾病和 TRM。第三方 UCB-MSC 输注是安全可行的。MSC 还可能增强 UCBT 的植入并预防排斥反应。此外，MSC 可能在降低 TRM 方面发挥作用。需要进行随机对照试验来证实这些结果，更长的随访时间将确定 MSC 对复发风险的影响。
