Liver fibrosis alleviation after co-transplantation of hematopoietic stem cells with mesenchymal stem cells in patients with thalassemia major

Ghavamzadeh, Ardeshir; Sotoudeh, Masoud; Taheri, Amir; Pashaiefar, Hossein; Jalili, Mahdi; Shahi, Farhad; Jahani, M.; Yaghmaie, Marjan

doi:10.1007/s00277-017-3181-9

Cited by 7 publications

(6 citation statements)

References 39 publications

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“…In a previous study, we showed that co-transplantation of HSC with MSCs increases the rate of replacement of recipient hepatocytes by donor-derived cells and may improve liver fibrosis; however, significant improvement in liver fibrosis was not seen in this study [58]. Some researchers believe that MSCs may reduce the risk of graft failure, possibly due to their immunosuppressive effect on alloreactive host T lymphocytes [59,60].…”

Section: Discussioncontrasting

confidence: 62%

The effect of bone marrow-derived mesenchymal stem cell co-transplantation with hematopoietic stem cells on liver fibrosis alleviation and survival in patients with class III β-thalassemia major

et al. 2021

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Background Hepatic fibrosis is a common complication in transfusion-dependent thalassemia patients. Data on the co-transplantation of mesenchymal stem cells (MSCs) with hematopoietic stem cells (HSCs) in beta-thalassemia major patients are scarce. Therefore, we aimed to evaluate the effect of co-transplantation of bone marrow-derived MSC with HSCs on the liver fibrosis alleviation and transplant outcomes in class III beta-thalassemia major. Methods Between April 1998 and January 2017, a total of 224 consecutive patients with class III beta-thalassemia major underwent allogeneic HSCT in the Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran. To assess liver fibrotic changes after transplantation, 47 patients participated in the MSC plus HSC group and 30 patients in the HSC only group at the end of the follow-up period. All patients underwent laboratory tests, especially serum ferritin and liver function testing, hepatic T2* MRI, liver biopsy, and FibroScan before and 2 years after transplantation. Kaplan-Meier curves were derived to determine survival and were compared using the log-rank test. Repeated-measure, mixed-effect linear regression models were used to examine the changes in liver fibrosis over time. Results The 10-year OS rate was 71.84% in the mesenchymal group and 61.89% in the non-mesenchymal group (P value = 0.294), while the 10-year TFS rate was 63.64% in the mesenchymal group and 52.78% in the non-mesenchymal group (P value = 0.285). No significant difference was observed in the 10-year NRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD between the two groups. In addition, the results of repeated-measure, mixed-effect linear regression models showed that none of the variables determining hepatic fibrosis had a significant difference between patients receiving MSCs and patients who did not receive MSCs. Conclusions Based on the results of this study, a single infusion of MSCs at the time of HSCT to patients with class III beta-thalassemia major could not significantly improve the liver fibrosis alleviation and transplantation outcomes, including OS, TFS, TRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD.

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Section: Discussioncontrasting

confidence: 62%

The effect of bone marrow-derived mesenchymal stem cell co-transplantation with hematopoietic stem cells on liver fibrosis alleviation and survival in patients with class III β-thalassemia major

et al. 2021

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“…As our institute has been conducting different researches to determine the impact of MSCs on various diseases, it was important to consider whether other aspects of transplantation would be affected by co-transplantation of MSCs together with HSCs or not. [10][11][12] In this standpoint, we aimed to compare the transplantation outcomes of class III thalassemia major patients who underwent co-transplantation of MSCs plus HSCs with those who only received HSCs.…”

Section: Introductionmentioning

confidence: 99%

Co‐transplantation of bone marrow‐derived mesenchymal stem cells with hematopoietic stem cells does not improve transplantation outcome in class III beta‐thalassemia major: A prospective cohort study with long‐term follow‐up

Rostami

Maleki

Kasaeian

et al. 2020

Pediatric Transplantation

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Bone marrow transplantation is the only curative treatment for beta-thalassemia major. Data on the co-transplantation of MSCs with HSCs in beta-thalassemia major patients are scarce. We aimed to investigate the outcomes of thalassemia major patients who underwent bone marrow-derived MSC co-transplantation with HSCs compared with those who only received HSCs. This prospective randomized study included patients with class III thalassemia major undergoing HSCT divided randomly into two groups: Thirty-three patients underwent co-transplantation of bone marrow-derived MSCs with HSCs, and 26 patients only received HSCs. Five-year OS, TFS, TRM, graft rejection rate, and GVHD were estimated. The 5-year OS was 66.54% (95% CI, 47.8% to 79.9%) in patients who underwent co-transplantation of MSCs with HSCs vs 76.92% (95% CI, 55.7% to 88.9%) in patients who only received HSCs (P = .54). No significant difference was observed in the 5-year TFS between the two groups (59.1% vs 69.2%; P = .49). The 5-year cumulative incidence of TRM was not statistically significant among patients who underwent co-transplantation of MSCs with HSCs (27.27%) vs those who only received HSCs (19.23%; P = .61). There was no statistically significant difference in graft rejection, acute GvHD, and chronic GvHD between the two groups. Based on our findings, the co-transplantation of MSCs and HSCs to class III thalassemia major patients does not alter their transplantation outcomes including OS, TFS, rejection rate, transplant-related mortality, and GvHD. K E Y W O R D S beta-thalassemia, hematopoietic stem cells, mesenchymal stem cells, outcome How to cite this article: Rostami T, Maleki N, Kasaeian A, et al. Co-transplantation of bone marrow-derived mesenchymal stem cells with hematopoietic stem cells does not improve transplantation outcome in class III beta-thalassemia major: A prospective cohort study with long-term follow-up. Pediatr

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“…In a previous study, we showed that co-transplantation of HSC with MSCs increases the rate of replacement of recipient hepatocytes by donor-derived cells and may improve liver brosis; however, signi cant improvement in liver brosis were not seen in this study. 58 Some researchers believe that MSCs may reduce the risk of graft failure, possibly due to their immunosuppressive effect on alloreactive host T lymphocytes. 59,60 In addition, it is mentioned that co-transplantation of MSCs and HSCs leads to rapid engraftment of ANC and platelets.…”

Section: Discussionmentioning

confidence: 99%

The Effect of Bone Marrow-Derived Mesenchymal Stem Cells Co-transplantation with Hematopoietic Stem Cells on Liver Fibrosis Alleviation and Survival in Patients with Class III β-thalassemia Major

Rostami

Kasaeian

Maleki

et al. 2021

Preprint

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Background: Hepatic fibrosis is a common complication in transfusion-dependent thalassemia patients. Data on the co-transplantation of mesenchymal stem cells (MSCs) with hematopoietic stem cells (HSCs) in beta-thalassemia major (BTM) patients are scarce. Therefore, we aimed to evaluate the effect of co-transplantation of bone marrow-derived MSC with HSCs on the liver fibrosis alleviation and transplant outcomes in class III BTM.Methods: Between April 1998 and January 2017, a total of 224 consecutive patients with class III BTM underwent allogeneic HSCT in the Research Institute for Oncology, Hematology and Cell Therapy, Tehran University of Medical Sciences, Tehran, Iran. To assess liver fibrotic changes after transplantation, 47 patients participated in the MSC plus HSC group and 30 patients in the HSC only group at the end of the follow-up period. All patients underwent laboratory tests, especially serum ferritin and liver function testing, hepatic T2* MRI, liver biopsy, and FibroScan before and two years after transplantation. Kaplan–Meier curves were derived to determine survival, and were compared using the log-rank test. Repeated-measure, mixed-effect linear regression models were used to examine changes in liver fibrosis over time.Results: The 10-year OS rate was 71.84% in the mesenchymal group and 61.89% in the non-mesenchymal group (P-value = 0.294), while the 10-year TFS rate was 63.64% in the mesenchymal group and 52.78% in the non-mesenchymal group (P-value = 0.285). No significant difference was observed in the 10-year NRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD between the two groups. In addition, the results of repeated-measure, mixed-effect linear regression models showed that none of the variables determining hepatic fibrosis had a significant difference between patients receiving MSCs and patients who did not receive MSCs.Conclusions: Based on the results of this study, the co-transplantation of bone marrow-derived MSCs and HSCs to patients with class III beta-thalassemia major could not significantly improve the liver fibrosis alleviation and transplantation outcomes, including OS, TFS, TRM, rejection rate, ANC engraftment, platelet engraftment, acute GvHD, and chronic GvHD.

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Liver fibrosis alleviation after co-transplantation of hematopoietic stem cells with mesenchymal stem cells in patients with thalassemia major

Cited by 7 publications

References 39 publications

The effect of bone marrow-derived mesenchymal stem cell co-transplantation with hematopoietic stem cells on liver fibrosis alleviation and survival in patients with class III β-thalassemia major

The effect of bone marrow-derived mesenchymal stem cell co-transplantation with hematopoietic stem cells on liver fibrosis alleviation and survival in patients with class III β-thalassemia major

Co‐transplantation of bone marrow‐derived mesenchymal stem cells with hematopoietic stem cells does not improve transplantation outcome in class III beta‐thalassemia major: A prospective cohort study with long‐term follow‐up

The Effect of Bone Marrow-Derived Mesenchymal Stem Cells Co-transplantation with Hematopoietic Stem Cells on Liver Fibrosis Alleviation and Survival in Patients with Class III β-thalassemia Major

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