Marcus Center for Cellular Cures, Duke University, Durham, NC, USA.
Department of Medicine, Duke University, Durham, NC, USA.
Stem Cells Transl Med. 2023 Apr 17;12(4):185-193. doi: 10.1093/stcltm/szad009.
Treatment options for patients with COVID-19-related acute respiratory distress syndrome (ARDS) are desperately needed. Allogeneic human umbilical cord derived mesenchymal stromal cells (hCT-MSCs) have potential therapeutic benefits in these critically ill patients, but feasibility and safety data are lacking.
In this phase I multisite study, 10 patients with COVID-19-related ARDS were treated with 3 daily intravenous infusions of hCT-MSCs (1 million cells/kg, maximum dose 100 million cells). The primary endpoint assessed safety.
Ten patients (7 females, 3 males; median age 62 years (range 39-79)) were enrolled at 2 sites and received a total of 30 doses of study product. The average cell dose was 0.93 cells/kg (range 0.56-1.45 cells/kg and total dose range 55-117 million cells) with 5/30 (17%) of doses lower than intended dose. Average cell viability was 85% (range 63%-99%) with all but one meeting the >70% release criteria. There were no infusion-related reactions or study-related adverse events, 28 non-serious adverse events in 3 unique patients, and 2 serious adverse events in 2 unique patients, which were expected and unrelated to the study product. Five patients died: 3 by day 28 and 5 by day 90 of the study (median 27 days, range 7-76 days). All deaths were determined to be unrelated to the hCT-MSCs.
We were able to collect relevant safety outcomes for the use of hCT-MSCs in patients with COVID-19-related ARDS. Future studies to explore their safety and efficacy are warranted.
COVID-19 相关急性呼吸窘迫综合征(ARDS)患者的治疗选择迫在眉睫。同种异体人脐带衍生间充质基质细胞(hCT-MSCs)对这些重症患者具有潜在的治疗益处,但缺乏可行性和安全性数据。
在这项 I 期多中心研究中,10 名 COVID-19 相关 ARDS 患者接受了 3 次每日静脉输注 hCT-MSCs(100 万细胞/kg,最大剂量 1 亿细胞)。主要终点评估安全性。
2 个中心共招募了 10 名患者(7 名女性,3 名男性;中位年龄 62 岁(范围 39-79)),共接受了 30 剂研究产品。平均细胞剂量为 0.93 细胞/kg(范围 0.56-1.45 细胞/kg,总剂量范围 55-11700 万细胞),其中 5/30(17%)剂量低于预期剂量。平均细胞活力为 85%(范围 63%-99%),除 1 剂外,所有细胞均符合>70%释放标准。无输注相关反应或研究相关不良事件,3 名独特患者出现 28 例非严重不良事件,2 名独特患者出现 2 例严重不良事件,均为预期且与研究产品无关。5 名患者死亡:3 名在第 28 天,5 名在第 90 天(中位 27 天,范围 7-76 天)。所有死亡均被认为与 hCT-MSCs 无关。
我们能够为 COVID-19 相关 ARDS 患者使用 hCT-MSCs 收集相关安全性结果。需要进一步研究以探索其安全性和疗效。