Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease

Donadel, Camila Derminio; Pires, Bruno Garcia; André, Nathália Cristine; Costa, Thalita Cristina Mello; Orellana, Maristela Delgado; Caruso, Sâmia Rigotto; Seber, Adriana; Ginani, Valéria Cortez; Gomes, Alessandra Araújo; Novis, Yana; Barros, George Maurício Navarro; Vilella, Neysimélia Costa; Martinho, Gláucia Helena; Vieira, Ana Karine; Kondo, Andrea Tiemi; Hamerschlak, Nelson; Filho, Jayr Schmidt; Xavier, Erick Menezes; Fernandes, Juliana Folloni; Rocha, Vanderson; Covas, Dimas Tadeu; Calado, Rodrigo Tocantins; Guerino-Cunha, Renato Luiz; De Santis, Gil Cunha

doi:10.3390/ph16040512

Open AccessArticle

Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease

by

Camila Derminio Donadel

¹

,

Bruno Garcia Pires

²

,

Nathália Cristine André

¹

,

Thalita Cristina Mello Costa

²,

Maristela Delgado Orellana

¹,

Sâmia Rigotto Caruso

¹,

Adriana Seber

^3,4,

Valéria Cortez Ginani

^3,4,

Alessandra Araújo Gomes

⁵

,

Yana Novis

⁵,

George Maurício Navarro Barros

⁶

,

Neysimélia Costa Vilella

⁶,

Gláucia Helena Martinho

⁷,

Ana Karine Vieira

⁷,

Andrea Tiemi Kondo

⁸,

Nelson Hamerschlak

⁸

,

Jayr Schmidt Filho

⁹,

Erick Menezes Xavier

¹⁰,

Juliana Folloni Fernandes

^8,11,

Vanderson Rocha

¹⁰,

Dimas Tadeu Covas

^1,2,

Rodrigo Tocantins Calado

^1,2,

Renato Luiz Guerino-Cunha

^2,†,‡ and

Gil Cunha De Santis

^1,2,*,†

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¹

Regional Blood Center of Ribeirão Preto, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil

²

Department of Medical Imaging, Hematology and Oncology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto 05508-220, Brazil

³

Grupo de Apoio ao Adolescente e à Criança com Câncer (GRAACC), Universidade Federal de São Paulo (UNIFESP), São Paulo 04021-001, Brazil

⁴

Hospital Samaritano, São Paulo 01232-010, Brazil

⁵

Hospital Sírio Libanês, São Paulo 01308-050, Brazil

⁶

Barretos Cancer Hospital, Barretos 14784-400, Brazil

⁷

Hospital das Clínicas da Universidade Federal de Minas Gerais, Belo Horizonte 30130-100, Brazil

⁸

Hospital Israelita Albert Einstein, São Paulo 05652-900, Brazil

⁹

Hospital A.C.Camargo Cancer Center, São Paulo 01525-001, Brazil

¹⁰

Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo (FMUSP), São Paulo 05403-010, Brazil

¹¹

Instituto da Criança do Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São Paulo 01246-903, Brazil

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^*

Author to whom correspondence should be addressed.

^†

These authors contributed equally to this work.

^‡

Present affiliation: Grupo Oncoclínicas & Instituto Oncoclínicas, São Paulo 04543-906, Brazil.

Pharmaceuticals 2023, 16(4), 512; https://doi.org/10.3390/ph16040512

Submission received: 8 March 2023 / Revised: 21 March 2023 / Accepted: 29 March 2023 / Published: 30 March 2023

(This article belongs to the Special Issue New Advances in Mesenchymal Stromal Cells as Therapeutic Tools)

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Abstract

Background: Steroid-refractory acute graft-vs.-host disease (SR-aGVHD) is a complication of allogeneic hematopoietic stem cell transplantation with a dismal prognosis and for which there is no consensus-based second-line therapy. Ruxolitinib is not easily accessible in many countries. A possible therapy is the administration of mesenchymal stromal cells (MSCs). Methods: In this retrospective study, 52 patients with severe SR-aGVHD were treated with MSCs from umbilical cord (UC-MSCs) in nine institutions. Results: The median (range) age was 12.5 (0.3–65) years and the mean ± SD dose (×10⁶/kg) was 4.73 ± 1.3 per infusion (median of four infusions). Overall (OR) and complete response (CR) rates on day 28 were 63.5% and 36.6%, respectively. Children (n = 35) had better OR (71.5% vs. 47.1%, p = 0.12), CR (48.6% vs. 11.8%, p = 0.03), overall survival (p = 0.0006), and relapse-free survival (p = 0.0014) than adults (n = 17). Acute adverse events (all of them mild or moderate) were detected in 32.7% of patients, with no significant difference in children and adult groups (p = 1.0). Conclusions: UC-MSCs are a feasible alternative therapy for SR-aGVHD, especially in children. The safety profile is favorable.

Keywords: mesenchymal stromal cell; hematopoietic stem cell transplantation; acute graft-versus-host disease

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MDPI and ACS Style

Donadel, C.D.; Pires, B.G.; André, N.C.; Costa, T.C.M.; Orellana, M.D.; Caruso, S.R.; Seber, A.; Ginani, V.C.; Gomes, A.A.; Novis, Y.; et al. Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease. Pharmaceuticals 2023, 16, 512. https://doi.org/10.3390/ph16040512

AMA Style

Donadel CD, Pires BG, André NC, Costa TCM, Orellana MD, Caruso SR, Seber A, Ginani VC, Gomes AA, Novis Y, et al. Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease. Pharmaceuticals. 2023; 16(4):512. https://doi.org/10.3390/ph16040512

Chicago/Turabian Style

Donadel, Camila Derminio, Bruno Garcia Pires, Nathália Cristine André, Thalita Cristina Mello Costa, Maristela Delgado Orellana, Sâmia Rigotto Caruso, Adriana Seber, Valéria Cortez Ginani, Alessandra Araújo Gomes, Yana Novis, and et al. 2023. "Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease" Pharmaceuticals 16, no. 4: 512. https://doi.org/10.3390/ph16040512

APA Style

Donadel, C. D., Pires, B. G., André, N. C., Costa, T. C. M., Orellana, M. D., Caruso, S. R., Seber, A., Ginani, V. C., Gomes, A. A., Novis, Y., Barros, G. M. N., Vilella, N. C., Martinho, G. H., Vieira, A. K., Kondo, A. T., Hamerschlak, N., Filho, J. S., Xavier, E. M., Fernandes, J. F., ... De Santis, G. C. (2023). Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease. Pharmaceuticals, 16(4), 512. https://doi.org/10.3390/ph16040512

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Umbilical Cord Mesenchymal Stromal Cells for Steroid-Refractory Acute Graft-versus-Host Disease

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