Co-transplantation of umbilical cord blood mesenchymal stem cells and haploidentical hematopoietic stem cells for treatment of severe aplastic anemia

doi:10.3969/j.issn.2095-4344.0663

Abstract

Abstract:

BACKGROUND: Nowadays the main therapy for severe aplastic anemia is immunosuppressive therapy or hematopoietic stem cell transplantation. With the development of hematopoietic stem cell transplantation technique, HLA-haploidentical hematopoietic stem cell transplantation is popularly used in the treatment of aplastic anemia. Mesenchymal stem cells as pluripotent stem cells can provide hematopoietic stem cells with ground substance and growth factors by interaction with hematopoietic stem cells in bone marrow. In addition, mesenchymal stem cells can inhibit the immunologic rejection and promote the immune reconstruction by regulating the immune function of the body.
OBJECTIVE: To explore the efficacy and safety of co-transplantation of umbilical cord blood mesenchymal stem cells and HLA-haploidentical hematopoietic stem cells for the treatment of severe aplastic anemia.
METHODS: From April 2015 to November 2017, six patients with severe aplastic anemia received fludarabine, cyclophosphamide and antithymocyte globilin as preconditioning before transplantation of HLA-haploidentical hematopoietic stem cells from the bone marrow and peripheral blood. Umbilical cord blood mesenchymal stem cells were infused before re-infusion of mobilized peripheral blood and bone marrow stem cells. Prophylaxis for graft-versus-host disease consisted of cyclosporine-A, short-course methotrexate as well as mycophenolate mofetil in patients.
RESULTS AND CONCLUSION: One of six cases died of severe infection at +102 days after transplantation, with neutrophil engraftment at +48 days, and platelets were not engrafted until died. The remaining five cases were in disease-free survival with the median neutrophil engraftment at +11 days, and the median platelet engraftment at +21 days after transplantation. Grade I to II acute graft-versus-host disease was observed in the two of six patients, and cytomegalovirus viremia in three patients as well as epstein-barr virus infection in one patient. Co-transplantation of umbilical cord blood mesenchymal stem cells and haploidentical hematopoietic stem cells can be a choice for refractory severe aplastic anemia without HLA-matched related or unrelated donor, which is worth exploring in the future.

中国组织工程研究杂志出版内容重点：干细胞；骨髓干细胞；造血干细胞；脂肪干细胞；肿瘤干细胞；胚胎干细胞；脐带脐血干细胞；干细胞诱导；干细胞分化；组织工程

Key words: Anemia, Aplastic, Hematopoietic Stem Cell Transplantation, Mesenchymal Stem Cell Transplantation, Tissue Engineering

CLC Number:

R394.2

Ren Juan, Zhao Juan, Wang Xiao-ning. Co-transplantation of umbilical cord blood mesenchymal stem cells and haploidentical hematopoietic stem cells for treatment of severe aplastic anemia[J]. Chinese Journal of Tissue Engineering Research, 2018, 22(33): 5297-5302.

Figures/Tables 1

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