Translational Cell Therapy Research (TCR), Department of Laboratory Medicine.
Center for Allogeneic Stem Cell Transplantation, Department of Oncology and Pathology.
Stem Cells Transl Med. 2018 Apr;7(4):325-331. doi: 10.1002/sctm.17-0167. Epub 2018 Mar 13.
Severe acute graft-versus-host disease (GVHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT). The placenta protects the fetus from the mother's immune system. We evaluated placenta-derived decidua stromal cells (DSCs), which differ from bone marrow mesenchymal stromal cells (BM-MSCs), as a treatment for severe acute GVHD. DSCs were obtained from term placentas. The DSCs were given to 38 patients with severe acute GVHD; 25 were steroid refractory (SR). DSCs were thawed and infused in buffer supplemented with either 10% AB plasma (group 1, n = 17), or 5% albumin (group 2, n = 21). The viability of cells was higher when thawed in albumin rather than AB plasma (p < .001). Group 1 received a higher cell dose (p < .001), cells of lower passage number (p < .001), and fewer infusions (p = .002) than group 2. The GVHD response (no/partial/complete) was 7/5/5 in group 1 and 0/10/11 in group 2 (p = .01). One-year survival in the two groups was 47% (95% confidence interval [CI] 23-68) and 76% (95% CI 51-89), respectively (p = .016). For the SR patients, 1-year survival was 73% (95% CI 37-90) in SR group 2 (n = 11), which was better than 31% (95% CI 11-54) in SR group 1 (n = 13; p = .02), 20% (95% CI 5-42) in BM-MSC treated (n = 15; p = .0015), and 3% (95% CI 0-14) in historic controls (n = 32; p < .001). DSCs are a promising new treatment for severe acute GVHD. Prospective randomized trials are needed for evaluation of efficacy. (Clinical trial NCT-02172937.) Stem Cells Translational Medicine 2018;7:325-332.
严重的急性移植物抗宿主病（GVHD）是异基因造血干细胞移植（HSCT）后的一种危及生命的并发症。胎盘保护胎儿免受母亲免疫系统的影响。我们评估了胎盘来源的基质细胞（DSC），它不同于骨髓间充质基质细胞（BM-MSC），作为治疗严重急性 GVHD 的一种方法。DSC 从足月胎盘获得。将 DSC 给予 38 名患有严重急性 GVHD 的患者；25 名是类固醇难治性（SR）患者。DSC 在含有 10%AB 血浆的缓冲液中解冻（第 1 组，n=17）或 5%白蛋白（第 2 组，n=21）中解冻和输注。在白蛋白中解冻的细胞活力高于在 AB 血浆中解冻（p<.001）。第 1 组接受了更高的细胞剂量（p<.001）、更低的传代数（p<.001）和更少的输注次数（p=.002）。第 1 组的 GVHD 反应（无/部分/完全）为 7/5/5，第 2 组为 0/10/11（p=.01）。两组 1 年生存率分别为 47%（95%置信区间[CI]23-68）和 76%（95%CI51-89）（p=.016）。对于 SR 患者，SR 第 2 组（n=11）的 1 年生存率为 73%（95%CI37-90），优于 SR 第 1 组（n=13）的 31%（95%CI11-54）（p=.02），BM-MSC 治疗组（n=15）的 20%（95%CI5-42）（p=.0015）和历史对照组（n=32）的 3%（95%CI0-14）（p<.001）。DSC 是治疗严重急性 GVHD 的一种很有前途的新方法。需要进行前瞻性随机试验来评估疗效。（临床试验 NCT02172937）。干细胞转化医学 2018；7:325-332。
