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

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 tissu
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.
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Author: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, Irene Teichert- von Lüttichau
URN:urn:nbn:de:hebis:30-112629
DOI:http://dx.doi.org/10.1186/1755-7682-4-27
Pubmed Id:http://www.ncbi.nlm.nih.gov/pubmed?term=21843360
Parent Title (English):International archives of medicine
Publisher:BioMed Central
Place of publication:London
Document Type:Article
Language:English
Date of Publication (online):2011/08/15
Date of first Publication:2011/08/15
Publishing Institution:Univ.-Bibliothek Frankfurt am Main
Release Date:2011/09/09
Volume:4
Issue:27
Pagenumber:9
First Page:1
Last Page:9
Note:
© 2011 Wernicke et al. ; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
HeBIS PPN:27458591X
Institutes:Medizin
Dewey Decimal Classification:610 Medizin und Gesundheit
Sammlungen:Universitätspublikationen
Licence (German):License LogoCreative Commons - Namensnennung 2.0

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