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Mesenchymal stromal cells for treatment of steroid-refractory GvHD : a review of the literature and two pediatric cases

By Caroline M. Wernicke, Thomas G. P. Grunewald, Hendrik Juenger, Selim Kuçi, Zyrafete Kuci, Ulrike Köhl, Ingo Mueller, Michaela Döring, Christina Peters, Anita Lawitschka, Hans-Jochem Kolb, Peter Bader, Stefan Burdach and Irene Teichert- von Lüttichau


Severe acute graft versus host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. Human mesenchymal stromal cells (MSCs) play an important role in endogenous tissue repair and possess strong immune-modulatory properties making them a promising tool for the treatment of steroid-refractory GvHD. To date, a few reports exist on the use of MSCs in treatment of GvHD in children indicating that children tend to respond better than adults, albeit with heterogeneous results. We here present a review of the literature and the clinical course of two instructive pediatric patients with acute steroid-refractory GvHD after haploidentical stem cell transplantation, which exemplify the beneficial effects of third-party transplanted MSCs in treatment of acute steroid-refractory GvHD. Moreover, we provide a meta-analysis of clinical studies addressing the outcome of patients with steroid-refractory GvHD and treatment with MSCs in adults and in children (n = 183; 122 adults, 61 children). Our meta-analysis demonstrates that the overall response-rate is high (73.8%) and confirms, for the first time, that children indeed respond better to treatment of GvHD with MSCs than adults (complete response 57.4% vs. 45.1%, respectively). These data emphasize the significance of this therapeutic approach especially in children and indicate that future prospective studies are needed to assess the reasons for the observed differential response-rates in pediatric and adult patients. Additional file 1: MSCs expansion and release criteria.his file contains a detailed description of the MSCs expansion and release criteria for Case A and Case B

Topics: ddc:610
Year: 2011
OAI identifier: oai:publikationen.ub.uni-frankfurt.de:22676

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