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Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

BACKGROUND: Allogeneic hematopoietic stem cell transplantation is an important or even the only potentially curative treatment for many hematological diseases. However, acute graft-versus-host disease is still one of the life-threatening complications after allogeneic hematopoietic stem cell transplantation. There is no standardized treatment for refractory acute graft-versus-host disease. Many studies indicated that mesenchymal stem cells may be used for treating acute graft-versus-host disease through the immunomodulatory effect; however, the actual effect is still to be confirmed. OBJECTIVE: To explore the efficacy and safety of human umbilical cord blood-derived mesenchymal stem cells in the treatment of refractory acute graft-versushost disease and the related factors for the efficacy. METHODS: Totally 24 patients who were diagnosed with refractory acute graft-versus-host disease patients and treated with third-party derived human umbilical cord blood-derived mesenchymal stem cells at the Hematopoietic Stem Cell Transplantation Center of the First Affiliated Hospital of Zhengzhou University were included in the present study. Among them, 8 cases were children, and 16 cases were adults; 10 cases were grade II acute graft-versus-host disease, and 14 cases were grades III-IV. The efficacy, adverse effects, recurrence of primary disease, secondary infection and long-term survival of these patients were observed. RESULTS AND CONCLUSION: (1) The median dose of total infused human umbilical cord blood-derived mesenchymal stem cells was 2.7×106/kg [(2.02- 6.00)×106/kg] with a median of 2.5 infusions (range, 2-6 times). The median time from the onset of acute graft-versus-host disease to first human umbilical cord blood-derived mesenchymal stem cells infusion was 12.5 days (range, 8-36 days). (2) The overall response rate at 28 days after infusion was 83% (20/24). The probability of 2-year overall survival was 33.3%. The 2-year overall survival for patients achieving complete remission and partial remission/non-remission were 57% and 0%, respectively (P < 0.000 1). There was significant difference between these two groups. (3) The efficacy for patients with grade II refractory acute graft-versus-host disease was better than grades III-IV (P=0.024). There was no remarkable difference in terms of age, involved organs, primary diseases and the number of infusions of human umbilical cord blood-derived mesenchymal stem cells. (4) In conclusion, treatment with human umbilical cord bloodderived mesenchymal stem cells is a safe and effective option for patients with refractory acute graft-versus-host disease. [ABSTRACT FROM AUTHOR]

BACKGROUND: The probability of obtaining sibling-matched hematopoietic stem cell transplantation donors for patients with severe aplastic anemia is less than 30%. With the recent improvement of unrelated peripheral blood stem cell transplantation, the efficacy of unrelated peripheral blood stem cell transplantation in the treatment of benign and malignant hematological diseases has reached a result similar to that of sibling-matched hematopoietic stem cell transplantation. OBJECTIVE: To evaluate the efficacy and safety of unrelated peripheral blood stem cell transplantation in the treatment of severe aplastic anemia. METHODS: A retrospective analysis was made in 25 severe aplastic anemia (type I and type II) patients who received unrelated peripheral blood stem cell transplantation from March 2014 to September 2019. All of them were sibling-matched hematopoietic stem cell transplantation-free patients who refused to accept immunosuppressive therapy. The transplantation pretreatment regimen was “fludarabine + cyclophosphamide + rabbit anti-human thymocyte globulin antibody”, and the prevention scheme of graft-versus-host disease was “cyclosporine + mycophenolate mofetil + short-term methotrexate”. The observation indicators included implantation rate, hematopoietic reconstitution time, incidence of graft-versus-host disease, incidence of transplantation-related complications, 5-year estimated overall survival rate and 5-year estimated disease-free survival rate. This study was approved by the Ethics Committee of the First Affiliated Hospital of Zhengzhou University. Patients and their family members signed the informed consent on unrelated peripheral blood stem cell transplantation. RESULTS AND CONCLUSION: (1) Three of the 25 patients died within 28 days after hematopoietic stem cell transplantation, and the implantation could not be evaluated. Of the remaining 22 patients, 21 cases (95.4%) obtained hematopoietic reconstitution and the implantation was successful; 1 case (4.6%) failed. The median time of neutrophil ≥ 0.5×109 L -1 and platelet ≥ 20×109 L -1 was 12 days (9-18 days) and 13 days (10-32 days), respectively. (2) Among the 21 patients with successful implantation, the incidence of acute graft-versus-host disease was 28.6% (6/21), including I-II degree in 3 cases and III–IV degree in 3 cases. There were only 9.5% patients with mild chronic graft-versus-host disease (2/21), and no moderate and severe chronic graft-versus-host disease occurred. (3) During the median follow-up of 396 days (15-1 886 days), 18 cases (72.0%) survived; the 5-year estimated overall survival rate was 71.1%; and the 5-year estimated disease-free survival rate was 65.6%. Totally 7 cases (28.0%) died, of which 3 cases (12.0%) died of infection, 2 cases (8.0%) died of acute intestinal graft-versus-host disease, 1 case (4.0%) died of intracranial hemorrhage, and 1 case (4.0%) died of multiple organ failure. (4) The results show that unrelated peripheral blood stem cell transplantation is a safe and effective treatment for severe aplastic anemia patients without sibling matching donor, and it is a feasible and useful alternative therapy. [ABSTRACT FROM AUTHOR]

Copyright of Chinese Journal of Tissue Engineering Research / Zhongguo Zuzhi Gongcheng Yanjiu is the property of Chinese Journal of Tissue Engineering Research and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)