Are Mesenchymal Stem Cells Still Effective in Acute GvHD Management?

• Published in: Transfusion and apheresis science 2024-12, Vol.64 (1), p.104051, Article 104051
• Main Authors: Ulu, Bahar Uncu, Hindilerden, Ipek Yonal, Yigenoglu, Tugce Nur, Tiryaki, Tarik Onur, Erkurt, Mehmet Ali, Korkmaz, Gulten, Namdaroglu, Sinem, Aksoy, Elif, Korkmaz, Serdal, Seyhan, Mert, Yilmaz, Seda, Besisik, Sevgi Kalayoglu, Dal, Mehmet Sinan, Ulas, Turgay, Altuntas, Fevzi
• Format: Article
• Language: English
• Subjects: Graft vs Host Disease; Hematopoietic Stem Cell Transplantation; Mesenchymal Stem Cells
• ISSN: 1473-0502
• DOI: 10.1016/j.transci.2024.104051

Graft-versus-host disease (GvHD) is a common and serious complication following allogeneic hematopoietic stem cell transplantation (allo-HSCT), significantly impacting transplant efficacy. In the treatment of GvHD, numerous therapeutic approaches have been explored, with mesenchymal stem cells (MSCs) emerging as a prominent immunomodulatory option. We aimed to evaluate efficacy and outcomes of using MSCs for steroid refractory acute GVHD (SR-aGvHD) management. We retrospectively analyzed data from 36 patients’ who received MSCs for treatment of SR-aGvHD following allo-HSCT between 2018 and 2024 from nine transplantation centers in Türkiye. The product consisted of umbilical cord-derived allogeneic MSCs, which were administered intravenously. Our cohort was at the median age of 39 years (range: 19-61 years), with aGvHD diagnosed at a median of two months after allo-HSCT. More than half of the patients (58.3%) classified as high-grade aGvHD according to the Minnesota risk scoring. Cord blood-derived MSCs were administered at a median dose of 3.45 (range: 0.8-5) million MSCs/kg, with a median of 3th (range: 2-5) line treatment. The rate of responses exceeding partial response (PR) was approximately 20% at the first month, increasing to 24% at the second month. The six-month survival rate was 33%, with 46% of mortality attributed to sepsis and 12.5% related to GvHD. Multivariate analysis indicated that increasing age (≥35 years) and lower platelet counts (≤75 x109/L) were associated with higher mortality (p