Umbilical cord-derived mesenchymal stem cells for steroid-refractory acute graft-versus-host disease: a real-world
Yanyan Niu1, Bin Chen1, Yaqian Zhao1
1Department of Hematology, Third Hospital of Shanxi Medical University, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Taiyuan, People's Republic of China.
Steroid-refractory acute graft-versus-host disease (SR-aGVHD), a severe complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) lacking standard second-line therapy, was studied in a retrospective analysis of 95 patients (2019-2024) at Third Hospital of Shanxi Medical University. We compared umbilical cord mesenchymal stem cells (UC-MSCs) plus standard care (n = 44) vs. standard care alone (n = 51). UC-MSCs were infused intravenously at 1-3 × 106 cells/kg with three infusions per patient. The MSC group had higher complete response (CR) rates than non-MSC group: 84.1% vs. 58.8% for grade II-IV SR-aGVHD (p = 0.007) and 54.5% vs. 31.4% for grade III-IV SR-aGVHD (p = 0.034) at week 4. Liver and gut CR rates improved by 31.8% and 28.1%, respectively. Multivariate analysis identified age ≥35 years, grade IV aGVHD, and hemoglobin ≤90 g/L as independent adverse prognostic factors. After median follow-up of 27 months, overall survival (OS) did not differ (HR = 1.04, p = 0.911). UC-MSCs improve early SR-aGVHD remission; prognostic factors enable risk stratification.
Steroid-refractory acute graft-versus-host disease (SR-aGVHD), a severe complication after allogeneic hematopoietic stem cell transplantation (allo-HSCT) lacking standard second-line therapy, was studied in a retrospective analysis of 95 patients (2019-2024) at Third Hospital of Shanxi Medical University. We compared umbilical cord mesenchymal stem cells (UC-MSCs) plus standard care (n = 44) vs. standard care alone (n = 51). UC-MSCs were infused intravenously at 1-3 × 106 cells/kg with three infusions per patient. The MSC group had higher complete response (CR) rates than non-MSC group: 84.1% vs. 58.8% for grade II-IV SR-aGVHD (p = 0.007) and 54.5% vs. 31.4% for grade III-IV SR-aGVHD (p = 0.034) at week 4. Liver and gut CR rates improved by 31.8% and 28.1%, respectively. Multivariate analysis identified age ≥35 years, grade IV aGVHD, and hemoglobin ≤90 g/L as independent adverse prognostic factors. After median follow-up of 27 months, overall survival (OS) did not differ (HR = 1.04, p = 0.911). UC-MSCs improve early SR-aGVHD remission; prognostic factors enable risk stratification.
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