Lynne M. Ball1, Maria Ester Bernardo2, Helene Roelofs3, Arjan Lankester1, Angela Cometa2, R. Maarten Egeler1, Franco Locatelli2, Willem E. Fibbe3
1Department of Pediatric Stem Cell Transplantation, Leiden University Medical Centre, Leiden, the Netherlands
2Pediatric Hematology/Oncology, Fondazione Istituti di Ricovero e Cura a Catattere Scientifico (IRCCS) Policlinico San Matteo, University of Pavia, Pavia, Italy
3Immunohematology and Stem Cell Research, Leiden University Medical Centre, Leiden, the Netherlands
Tóm tắt
Haploidentical hematopoietic stem-cell transplantation (HSCT) is associated with an increased risk of graft failure. Adult bone marrow–derived mesenchymal stromal cells (MSCs) have been shown to support in vivo normal hematopoiesis and to display potent immune suppressive effects. We cotransplanted donor MSCs in 14 children undergoing transplantation of HLA-disparate CD34+ cells from a relative. While we observed a graft failure rate of 15% in 47 historic controls, all patients given MSCs showed sustained hematopoietic engraftment without any adverse reaction. In particular, children given MSCs did not experience more infections compared with controls. These data suggest that MSCs, possibly thanks to their potent immunosuppressive effect on alloreactive host T lymphocytes escaping the preparative regimen, reduce the risk of graft failure in haploidentical HSC transplant recipients.
