dc.contributor.author | Keklik, Muzaffer | |
dc.contributor.author | Deveci, Burak | |
dc.contributor.author | Çelik, Serhat | |
dc.contributor.author | Deniz, Kemal | |
dc.contributor.author | Gönen, Zeynep Burçin | |
dc.contributor.author | Zararsız, Gökmen | |
dc.contributor.author | Saba, Rabin | |
dc.contributor.author | Ünal, Ali | |
dc.date.accessioned | 2024-02-22T06:21:38Z | |
dc.date.available | 2024-02-22T06:21:38Z | |
dc.date.issued | 2023 | en_US |
dc.identifier.citation | Keklik, M., Deveci, B., Çelik, S., Deniz, K., Gönen, Z. B., Zararsız, G. ... Ünal, A. (2023). Safety and efficacy of mesenchymal stromal cell therapy for multi-drug-resistant acute and late-acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation. Annals of Hematology, 102(6), 1537-1547. https://dx.doi.org/10.1007/s00277-023-05216-3 | en_US |
dc.identifier.issn | 0939-5555 | |
dc.identifier.issn | 1432-0584 | |
dc.identifier.uri | https://dx.doi.org/10.1007/s00277-023-05216-3 | |
dc.identifier.uri | https://hdl.handle.net/20.500.12511/12299 | |
dc.description.abstract | Graft versus host disease (GvHD) remains a significant risk for mortality and morbidity following allogeneic hematopoietic stem cell transplantation (HSCT). A growing literature supports successful applications of mesenchymal stromal cells (MSCs) for the treatment of steroid-refractory acute GvHD (aGvHD). However, there is limited knowledge about the effects of MSC treatment on late-acute GvHD (late aGvHD). In this article, we present our multicenter study on the safety and efficacy of MSC therapy for patients with steroid-refractory late aGvHD in comparison to those with aGvHD. The outcome measures include non-relapse mortality (NRM) and survival probability over a 2-year follow-up. The study includes a total of 76 patients with grades III-IV aGvHD (n = 46) or late aGvHD (n = 30), who had been treated with at least two lines of steroid-containing immunosuppressive therapy. Patients received weekly adipose or umbilical cord-derived MSC infusions at a dose of median 1.55 (ranging from 0.84 to 2.56) x 10(6)/kg in the aGvHD group, and 1.64 (ranging from 0.85 to 2.58) x 10(6)/kg in the late aGvHD group. This was an add-on treatment to ongoing conventional pharmaceutical management. In the aGvHD group, 23 patients received one or two infusions, 20 patients had 3-4, and three had >= 5. Likewise, in the late aGvHD group, 20 patients received one or two infusions, nine patients had 3-4, and one had >= 5. MSC was safe without acute or late adverse effects in 76 patients receiving over 190 infusions. In aGvHD group, 10.9% of the patients had a complete response (CR), 23.9% had a partial response (PR), and 65.2% had no response (NR). On the other hand, in the late aGvHD group, 23.3% of the patients had CR, 36.7% had PR, and the remaining 40% had NR. These findings were statistically significant (p = 0.031). Also, at the 2-year follow-up, the cumulative incidence of NRM was significantly lower in patients with late aGvHD than in patients with aGvHD at 40% (95% CI, 25-62%) versus 71% (95% CI, 59-86%), respectively (p = 0.032). In addition, the probability of survival at 2 years was significantly higher in patients with late aGvHD than in the aGvHD group at 59% (95% CI, 37-74%) versus 28% (95% CI, 13-40%), respectively (p = 0.002). To our knowledge, our study is the first to compare the safety and efficacy of MSC infusion(s) for the treatment of steroid-resistant late aGVHD and aGVHD. There were no infusion-related adverse effects in either group. The response rate to MSC therapy was significantly higher in the late aGvHD group than in the aGvHD group. In addition, at the 2-year follow-up, the survival and NRM rates were more favorable in patients with late aGVHD than in those with aGVHD. Thus, the results are encouraging and warrant further studies to optimize MSC-based treatment for late aGVHD. | en_US |
dc.language.iso | eng | en_US |
dc.publisher | Springer | en_US |
dc.rights | info:eu-repo/semantics/embargoedAccess | en_US |
dc.subject | Allogeneic Hematopoietic Stem Cell Transplantation | en_US |
dc.subject | Graft-Versus-Host Disease | en_US |
dc.subject | Mesenchymal Stromal Cells | en_US |
dc.title | Safety and efficacy of mesenchymal stromal cell therapy for multi-drug-resistant acute and late-acute graft-versus-host disease following allogeneic hematopoietic stem cell transplantation | en_US |
dc.type | article | en_US |
dc.relation.ispartof | Annals of Hematology | en_US |
dc.department | İstanbul Medipol Üniversitesi, Tıp Fakültesi, Dahili Tıp Bilimleri Bölümü, İç Hastalıkları Ana Bilim Dalı | en_US |
dc.authorid | 0000-0002-2035-9462 | en_US |
dc.identifier.volume | 102 | en_US |
dc.identifier.issue | 6 | en_US |
dc.identifier.startpage | 1537 | en_US |
dc.identifier.endpage | 1547 | en_US |
dc.relation.publicationcategory | Makale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanı | en_US |
dc.identifier.doi | 10.1007/s00277-023-05216-3 | en_US |
dc.institutionauthor | Kaynar, Leylagül | |
dc.identifier.wosquality | Q2 | en_US |
dc.identifier.wos | 000970703200001 | en_US |
dc.identifier.scopus | 2-s2.0-85153111378 | en_US |
dc.identifier.pmid | 37067556 | en_US |
dc.identifier.scopusquality | Q1 | en_US |