脐带间充质干细胞治疗难治性慢性移植物抗宿主病的疗效观察

Clinical efficacy of umbilical cord-derived menchymal stem cell treatment of refractory chronic graft-versus-host disease

目的探讨脐带来源间充质干细胞（MSC）治疗异基因造血干细胞移植术后难治性慢性移植物抗宿主病（cGVHD）的疗效及安全性。方法 7例恶性血液病患者接受异基因造血干细胞移植术后出现cGVHD,常规免疫抑制剂治疗无效,在原有免疫抑制剂基础上给予脐带来源MSC治疗,细胞数1×10-6/kg,每周1次,共4次。观察其疗效、安全性和患者存活情况。结果 7例患者接受MSC输注后,2例获得完全缓解（CR）,3例部分缓解（PR）,总有效5例（5/7）,2例无效（NR）。未发现输注相关不良反应,无患者出现原发病复发。1例患者部分缓解后继发巨细胞病毒肺炎,死于重症肺炎,其余病例均存活。结论脐带MSC对于治疗难治性cGVHD具有一定的疗效,且输注过程安全。

Objective To evaluate the clinical efficacy and safety of umbilical cord-derived mesenchymal stem cell（MSC） treatment of refractory chronic graft-versus-host disease（cGVHD） after allogene hematopoietic stem cell transplantation. Methods Seven patients developed with c GVHD following allogene hematopoietic stem cell transplantation. Conventional immunosuppressive agent treatment yielded no efficacy. Based upon immunosuppressive agent therapy,umbilical cord-derived MSC treatment was supplemented with a cell density of 1 × 10-6/ kg,once a week for consecutive 4 times. Clinical efficacy,safety and survival of the patients were observed. Results Among 7 patients receiving MSC injection,2 obtained complete response（CR） and 3 had partial response（PR） with an overall response rate of 5 /7,and the remaining 2 cases achieved no response（NR）. No adverse reactions were induced by MSC injection. No patient had primary disease recurrence. One patient developed secondary cytomegalovirus pneumonia after PR and died from severe pneumonia. The remaining patients survived. Conclusions Umbilical cord-derived MSC injection is an efficacious and safe therapy of cGVHD.