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ctt-journal > Minakovskaya et al. (Abstract)

Minakovskaya et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 2, No. 5, 2009
doi: 10.3205/ctt-2009-No5-abstract30
© The Authors. This abstract is provided under the following license:
Creative Commons Attribution 3.0 Unported


Abstract accepted for "Joint EBMT Pediatric Working Party – 3rd Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation", Saint Petersburg, Russia, September 17–20, 2009

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Applying mesenchymal stem cells for the prevention and treatment of steroid-resistant GVHD in children in Belarus

Nina V. Minakovskaya, Yanina I. Isaikina, Olga V. Aleinikova

Belarusian Research Center for Pediatric Oncology and Hematology, Minsk, Belarus

Correspondence: Nina V. Minakovskaya, Belarusian Research Center for Pediatric Oncology and Hematology, Minski distr., Pos. Lesnoe, Minsk, Belarus, 223053, Phone: +375 17 265 40 89, Fax: +375-17-265-42-22, E-mail: minakovskaya@tut.by

Abstract

Objective: We analyzed the clinical effect of MSC infusion on day +30 after
HSCT as a GVHD prophylaxis and the application of MSCs as a treatment of severe steroid–resistant GVHD.

Patients and methods: Nine pts after allogeneic hematopoietic stem cell transplantation (HSCT) underwent MSC infusions (median age was 11 years, 6 males, 3 females) between 2006 and 2009.

Diagnoses: ALL – 4, AML – 1, AA – 3, MDS – 1. GVHD prophylaxis for pts with ALL and MDS consisted of CSA and MTX 10 mg/m2 (n=3); for pts with AA, CSA+MMF; for pts with AML, CSA and MTX 10 mg/m2 (n=4). For the treatment of GVHD all pts received methylprednisolone 1–2 mg/kg. Five pts received MSCs once and 4 pts, twice. For 4 pts MSCs were used as a GVHD prophylaxis on day +30 after HSCT; the median dose was 1.0 (0.7–1.5)x10^6/kg. Five pts received MSCs for the treatment of steroid–resistant GVHD with a medium time of MSC infusion after HSCT of 126 (110–151) days and a mean dose of 2.2 (1.3–3.7)x10^6/kg.

Results:
There was no evidence of early or late side effects of MSC infusion. One patient died from pulmonary GVHD 1 month after MSC infusion, while eight pts are alive. All pts (n=4) who received MSCs on day +30 as a GVHD prophylaxis developed grades II–IV GVHD and needed a secondary MSC infusion; the median time between MSC infusions was 120(90–150) days.

Four pts out of five with steroid-resistant GVHD showed significant improvement of the clinical signs of GVHD; this allowed the reduction of immunosuppressive therapy and the cessation of steroids.

Conclusion: Our experience demonstrates the absence of a positive GVHD prophylactic efficacy when MSC infusion was carried out on day +30. However, we observed a decrease of GVHD grades III–IV to 0–II, when MSCs were used as a treatment of steroid-resistant GVHD.

Keywords:
GVHD, MSC, allogeneic HSCT

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