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首页> 外文期刊>Biology of blood and marrow transplantation: journal of the American Society for Blood and Marrow Transplantation >Mesenchymal stem cells versus mesenchymal stem cells combined with cord blood for engraftment failure after autologous hematopoietic stem cell transplantation: A pilot prospective, open-label, randomized trial
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Mesenchymal stem cells versus mesenchymal stem cells combined with cord blood for engraftment failure after autologous hematopoietic stem cell transplantation: A pilot prospective, open-label, randomized trial

机译：间充质干细胞与间充质干细胞联合脐带血用于自体造血干细胞移植后的移植失败：一项前瞻性，开放标签，随机试验

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摘要

Engraftment failure (EF) after autologous hematopoietic stem cell transplantation is a serious complication. We prospectively evaluated the effects and safeties of mesenchymal stem cells (MSCs) alone and MSCs combined with cord blood (CB) for EF. Twenty-two patients were randomized to receive MSCs (MSC group; n=11) or MSCs plus CB (CB group; n=11). Patients with no response (NR) to MSCs received the therapeutic schedule in the CB group, and those patients with partial response (PR) in the MSC group and patients without complete remission (CR) in the CB group received another cycle of MSC treatment. Patients who did not achieve CR after 2 cycles of treatments received other treatments, including allogeneic HSCT. After the first treatment cycle, response was seen in 7 of 11 patients in the MSC group and in 9 of 11 in the CB group (P= 635), with a significant difference in neutrophil reconstruction between the 2 groups (P= 030). After 2treatment cycles, 16 patients achieved CR, 3 achieved PR, and 3 had NR. No patient experienced graft-versus-host disease (GVHD). With a median follow-up of 345d (range, 129 to 784d) post-transplantation, 18 patients remained alive and 4 had died (3 from primary disease relapse and 1 from cytomegalovirus pneumonia). The 2-year overall survival, disease-free survival, and cumulative incidence of tumor relapse post-transplantation were 75.2%±12.0%, 79.5%±9.4%, and 20.5%±9.4%, respectively. Our data indicate that the 2 strategies are effective for EF and do not result in GVHD or increase the risk of tumor relapse, but the MSC plus CB regimen has a superior effect on neutrophil reconstruction.
机译：自体造血干细胞移植后的植入失败（EF）是一种严重的并发症。我们前瞻性评估了单独的间充质干细胞（MSCs）和MSCs与脐带血（CB）联合治疗EF的效果和安全性。 22名患者被随机分配接受MSCs（MSC组; n = 11）或MSCs加CB（CB组; n = 11）。对MSC无反应（NR）的患者在CB组中接受了治疗方案，而在MSC组中具有部分反应（PR）的患者和CB组中无完全缓解（CR）的患者接受了另一轮MSC治疗。在2个疗程后未达到CR的患者接受了其他治疗，包括同种异体HSCT。在第一个治疗周期后，MSC组的11名患者中有7名发生反应，而CB组的11名患者中有9名发生反应（P = 635），两组之间的中性粒细胞重建存在显着差异（P = 030）。在2个治疗周期后，16例患者获得CR，3例达到PR，3例未达到NR​​。没有患者经历过移植物抗宿主病（GVHD）。移植后的中位随访时间为345d（范围为129至784d），有18例患者仍然存活，有4例死亡（3例因原发疾病复发，1例因巨细胞病毒性肺炎）。移植后的2年总生存率，无病生存率和肿瘤复发的累积发生率分别为75.2％±12.0％，79.5％±9.4％和20.5％±9.4％。我们的数据表明，这两种策略对于EF都是有效的，不会导致GVHD或增加肿瘤复发的风险，但是MSC加CB方案对中性粒细胞的重建具有更好的作用。

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