Department of Hematology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
J Int Med Res. 2020 May;48(5):300060520920438. doi: 10.1177/0300060520920438.
Mesenchymal stem cells (MSCs) may be used to treat steroid-refractory graft versus host disease (GVHD). However, the effects of MSCs in haploidentical peripheral blood stem cell transplantation (haplo-PBSCT) have not been confirmed in randomized studies.
We conducted a randomized clinical study to investigate the effects of pre-infusion (1 × 10 cells/kg) MSCs on hematopoietic recovery, Epstein-Barr and cytomegalovirus infection, GVHD, and relapse in patients undergoing haplo-PBSCT. Fifty patients with acute leukemia or myelodysplastic syndrome were randomly divided into an MSC group administered 1 × 10 MSCs/kg 4 to 6 hours before infusion of peripheral stem cells and a control group without MSCs.
Mean platelet engraftment time was significantly faster in the MSC compared with the control group (12.28 vs 13.29 days). The mean neutrophil engraftment time was comparable in both groups (10.76 ± 2.40 vs. 10.29 ± 1.72 days). Grade II or above acute GVHD was significantly decreased in the MSC compared with the control group (12% vs. 36%). There were no significant differences in relapse rate or overall survival between the groups.
These results suggest that pre-infusion single-dose MSCs promote platelet engraftment and decrease severe acute GVHD without increasing relapse rate.
间充质干细胞（MSCs）可用于治疗激素难治性移植物抗宿主病（GVHD）。然而，在随机研究中尚未证实 MSCs 在单倍体外周血造血干细胞移植（haplo-PBSCT）中的作用。
我们进行了一项随机临床试验，以研究输注前（1×10 个细胞/kg）MSCs 对接受 haplo-PBSCT 的患者造血恢复、Epstein-Barr 和巨细胞病毒感染、GVHD 和复发的影响。50 例急性白血病或骨髓增生异常综合征患者随机分为 MSC 组（在输注外周干细胞前 4 至 6 小时给予 1×10 MSCs/kg）和对照组（未给予 MSCs）。
MSC 组的血小板植入时间明显快于对照组（12.28 天 vs. 13.29 天）。两组的中性粒细胞植入时间相似（10.76±2.40 天 vs. 10.29±1.72 天）。MSC 组的 II 级或以上急性 GVHD 发生率明显低于对照组（12% vs. 36%）。两组的复发率或总生存率无显著差异。
这些结果表明，输注前单次剂量 MSCs 可促进血小板植入，并降低严重急性 GVHD 的发生率，而不会增加复发率。
