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脐带间充质干细胞治疗异基因造血干细胞移植后闭塞性细支气管炎的临床观察。

Clinical observation on the safety and efficacy of umbilical cord mesenchymal stem cells in the treatment of bronchiolitis obliterans after allogeneic haematopoietic stem cell transplantation.

机构信息

Department of Hematology, The Affiliated Cancer Hospital of Zhengzhou University & Henan Cancer Hospital, Zhengzhou, China.

Research and Transformation Center of Stem Cell And Regenearative Medicine, Henan Academy of Medical Sciences Zhengzhou, China.

出版信息

Biotechnol Genet Eng Rev. 2024 Apr;40(1):341-358. doi: 10.1080/02648725.2023.2183611. Epub 2023 Mar 1.

Abstract

Graft-versus-host disease (GVHD) is caused by a pathologic and destructive response of the organism as a result of the interaction between donor immunocompetent T lymphocytes and the recipient tisular antigens1. Graft-versus-host disease is considered a serious complication of hematopoietic stem cell transplantation. The skin, oral cavity and lungs are commonly affected organs. Among these complications bronchiolitis obliterans syndrome is a serious complication, which even can be life-threatening. Therefore, this research aims to do a clinical observation on the safety and efficacy of umbilical cord mesenchymal stem cells in the treatment of bronchiolitis obliterans after allogeneic haematopoietic stem cell transplantation. Fifteen patients were included in this study, who received allogeneic hematopoietic stem cell transplantation. Among these patients, both of them were treated with azithromycin, montelukast, glucocorticoid and pirfenidone. Two of them did not receive second line anti-rejection treatment due to economic reasons, and three of them were treated with mesenchymal stem cells. These bronchiolitis obliterans syndrome-related symptoms such as shortness of breath, chest tightness and wheezing have improved. Two of them died due to bronchiolitis obliterans syndrome related complications such as respiratory failure. Two of them not only improve the symptoms but also increased the FEV1/FVC, who were treated with mesenchymal stem cells. The comprehensive treatment regimen containing imatinib and ruxolitinib is safe and effective and mesenchymal stem cell is a promising treatment option to improve the prognosis of post-HSCT BOS.

摘要

移植物抗宿主病(GVHD)是由供者免疫活性 T 淋巴细胞与受者组织抗原相互作用,导致机体发生病理性、破坏性反应引起的。GVHD 被认为是造血干细胞移植的严重并发症。皮肤、口腔和肺部是常见的受累器官。在这些并发症中,闭塞性细支气管炎综合征是一种严重的并发症,甚至可能危及生命。因此,本研究旨在对脐带间充质干细胞治疗异基因造血干细胞移植后闭塞性细支气管炎的安全性和疗效进行临床观察。本研究纳入了 15 例接受异基因造血干细胞移植的患者。这些患者中,均采用阿奇霉素、孟鲁司特、糖皮质激素和吡非尼酮进行治疗。其中 2 例患者因经济原因未接受二线抗排斥治疗,3 例患者接受了间充质干细胞治疗。这些闭塞性细支气管炎综合征相关症状如呼吸困难、胸闷和喘息均得到改善。其中 2 例患者因呼吸衰竭等闭塞性细支气管炎综合征相关并发症死亡。2 例不仅改善了症状,而且还提高了 FEV1/FVC 值,他们接受了间充质干细胞治疗。含伊马替尼和鲁索利替尼的综合治疗方案安全有效,间充质干细胞是改善 post-HSCT BOS 预后的有前途的治疗选择。

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