Third-party Wharton?s jelly mesenchymal stem cells for treatment of steroid-resistant acute and chronic graft-versus-host disease: a report of 10 cases

Authors: DARIUSZ BORUCZKOWSKI, DOMINIKA GLADYSZ, SLAWOMIR RUMINSKI, IWONA CZAPLICKA-SZMAUS, MAGDALENA MURZYN, ARTUR OLKOWICZ, KRZYSZTOF KALWAK, MONIKA MIELCAREK, KATARZYNA DRABKO, JAN STYCZYNSKI, MIROSLAW MARKIEWICZ, KATARZYNA PAWELEC, MACIEJ BORUCZKOWSKI, TOMASZ OLDAK

Abstract: Severe graft-versus-host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT). Bone marrow mesenchymal stem cells (BM-MSCs) display immunosuppressive activity and have been previously shown to improve the outcome of GvHD therapy. We describe the use of umbilical cord mesenchymal stem cells (WJ-MSCs) expanded in serum-free medium for the treatment of acute GvHD (aGvHD) and chronic GvHD (cGvHD) in 10 patients. After 1 to 3 WJ-MSC infusions at a median dose of 1.5 × 10⁶ cells/kg recipient body weight, a complete or partial response was observed in 4/7 patients with aGvHD and in 2/3 patients with cGvHD. Five out of 6 patients (83.3%) from the responders group and only 1 out of 4 nonresponders (25%) survived the follow-up. The deaths occurred in patients with acute GvHD. In the responders group, 2 patients showed complete remission of GvHD while symptoms of 4 patients were alleviated and the intensity of immunosuppressive therapy could be reduced. No serious adverse effects were observed. In conclusion, WJ-MSCs appear to be safe and can be successfully applied in the treatment of acute and chronic GvHD, but the therapeutic conditions should be optimized in prospective studies to maximize their efficacy.

Keywords: Umbilical cord, mesenchymal stem cells, hematopoietic stem cell transplantation, graft-versus-host disease, Wharton?s jelly

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