Long-term Outcomes of Autologous Peripheral Blood Stem Cell Transplantation in Patients With Cirrhosis

Guo, Changcun; Guo, Guanya; Zhou, Xia; Chen, Yu; Han, Zheyi; Yang, Caifeng; Zhao, Shufang; Su, Hongling; Lian, Zhe‐Xiong; Leung, Patrick S.C.; Gershwin, M. Eric; Zhou, Xinmin; Han, Ying

doi:10.1016/j.cgh.2018.10.034

Cited by 10 publications

(12 citation statements)

References 42 publications

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“… 52 Recently, a long-term analysis of patients receiving peripheral blood-derived stem cells indicated a significant improvement in the long-term survival rate when compared to the control group, and the risk of hepatocellular carcinoma formation did not increase. 53 CD133 + HSC infusion was performed in a multicentre, open, randomized controlled phase 2 trial in patients with liver cirrhosis; the results did not support the improvement of liver conditions, and cirrhosis persisted. 54 Notably, these results are in line with a previous randomized controlled study, which also reported that G-CSF and bone marrow-derived stem cells delivered via the hepatic artery did not introduce therapeutic potential as expected.…”

Section: Stem Cell-based Therapy: An Overview Of Current Clinical App...mentioning

confidence: 97%

Stem cell-based therapy for human diseases

Hoang

Pham

Bach

et al. 2022

Sig Transduct Target Ther

283

138

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Recent advancements in stem cell technology open a new door for patients suffering from diseases and disorders that have yet to be treated. Stem cell-based therapy, including human pluripotent stem cells (hPSCs) and multipotent mesenchymal stem cells (MSCs), has recently emerged as a key player in regenerative medicine. hPSCs are defined as self-renewable cell types conferring the ability to differentiate into various cellular phenotypes of the human body, including three germ layers. MSCs are multipotent progenitor cells possessing self-renewal ability (limited in vitro) and differentiation potential into mesenchymal lineages, according to the International Society for Cell and Gene Therapy (ISCT). This review provides an update on recent clinical applications using either hPSCs or MSCs derived from bone marrow (BM), adipose tissue (AT), or the umbilical cord (UC) for the treatment of human diseases, including neurological disorders, pulmonary dysfunctions, metabolic/endocrine-related diseases, reproductive disorders, skin burns, and cardiovascular conditions. Moreover, we discuss our own clinical trial experiences on targeted therapies using MSCs in a clinical setting, and we propose and discuss the MSC tissue origin concept and how MSC origin may contribute to the role of MSCs in downstream applications, with the ultimate objective of facilitating translational research in regenerative medicine into clinical applications. The mechanisms discussed here support the proposed hypothesis that BM-MSCs are potentially good candidates for brain and spinal cord injury treatment, AT-MSCs are potentially good candidates for reproductive disorder treatment and skin regeneration, and UC-MSCs are potentially good candidates for pulmonary disease and acute respiratory distress syndrome treatment.

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Section: Stem Cell-based Therapy: An Overview Of Current Clinical App...mentioning

confidence: 97%

Stem cell-based therapy for human diseases

Hoang

Pham

Bach

et al. 2022

Sig Transduct Target Ther

283

138

View full text Add to dashboard Cite

show abstract

“…A recent study with up to 10 years of follow-up demonstrated the e cacy of autologous peripheral blood stem cells in the treatment of liver cirrhosis. 15 Our previous clinical trials have shown that UC-MSC treatment improves liver function in decompensated liver cirrhosis patients and ACLF patients during 72-week follow-up; however, the longterm effect of UC-MSC treatment in these patients remains uncertain. To address these issues, in our study, the long-term e cacy and safety of UC-MSC infusions in the treatment of patients with decompensated liver cirrhosis were observed for 75 months, which is the longest follow-up period reported so far for UC-MSC treatment of this condition.…”

Section: Introductionmentioning

confidence: 99%

Mesenchymal Stem Cell Therapy in Decompensated Liver Cirrhosis: A Long-Term Follow-up Analysis of the Randomized Controlled Clinical Trial

Shi

et al. 2021

Preprint

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BackgroundMesenchymal stem cells (MSC) infusion was reported to improve liver function in patients with decompensated liver cirrhosis (DLC), however, whether the medication can improve outcome of these patients is poorly understand.MethodsThis prospective, open-labeled, randomized controlled study enrolled 219 patients with HBV-related DLC who were divided into control group (n=111) and umbilical cord-derived MSC (UC-MSC) treated group (n=108), then all of them received a follow-up check from October 2010 to October 2017. The treated patients received three times of UC-MSC infusions at 4-week intervals plus conventional treatment that was only used for control group. The overall survival rate and HCC-free survial rate were calculated as primary endpoints and the liver function and adverse events associated with the medication were also evaluated.ResultsDuring the follow-up check period from 13th to 75th months, there was a significantly higher overall survival rate in the treated group than the control group, while the difference of the hepatocellular carcinoma event-free survival rate between the treated and control groups was not observed during the 75-month follow-up. UC-MSC treatment markedly improved liver function, as indicated by the levels of serum albumin, prothrombin activity, cholinesterase, and total bilirubin during 48 weeks of follow-up. No significant side effects or treatment-related complications were observed in the UC-MSC group.ConclusionsTherapy of UC-MSC is not only well tolerated, but also significantly improves long-term survival rate, as well as the liver function in patients with DLC. UC-MSC medication, therefore, might present a novel therapeutic approach for the disease.

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“…The study found that after propensity score matching, survival was significantly higher in patients receiving stem cell infusion (71.2% vs. 52.1%, p = 0.001) than in the control group. 16 The beneficial effect of this study, when compared with our research, could be due to the patient population having had a lower Child-Pugh score, and the majority of the patients being without ascites. So, it could be hypothesized that if stem cells are used early in the course of the natural history of cirrhosis, when the inflammatory milieu 17 of the liver is still less hostile to the mobilized or infused stem cells, the regenerative power of the cells could be better.…”

Section: Discussionmentioning

confidence: 49%

Long-term Outcome of Autologous Hematopoietic Stem Cell Infusion in Cirrhosis: Waning Effect over Time

Sharma¹,

Kulkarni²,

Sasikala³

et al. 2020

Journal of Clinical and Translational Hepatology

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Background and Aims: Long-term data on cell-based therapies, including hematopoietic stem cell infusion in cirrhosis, are sparse and lacking. Methods: Patients with cirrhosis of non-viral etiology received either standard-of-care (n = 23) or autologous CD34+ cell infusion through the hepatic artery (n = 22). Study patients received granulocyte colony-stimulating factor (commonly known as G-CSF) injections at 520 mgm per day for 3 days, followed by leukapheresis and CD34+ cell infusion into the hepatic artery. The Control group received standard-of-care treatment. Results: Mean CD34+ cell count on the third day of G-CSF injection was 27.00 ± 20.43 cells/mL 81.84 ± 11.99 viability and purity of 80-90%. Significant improvement in the model of endstage liver disease (commonly known as MELD) score (15.75 ± 5.13 vs. 19.94 ± 6.68, p = 0.04) was noted at end of 3 months and 1 year (15.5 ± 5.3 vs. 19.8 ± 6.4, p = 0.04) but was not statistically different at end of the second (17.2 ± 5.5 vs. 20.3 ± 6.8, p = 0.17) and third-year (18.4 ± 6.1 vs. 21.3 ± 6.4, p = 0.25). No difference in mortality (6/23 vs. 5/23) was noted. Conclusions: Autologous CD34+ cell infusion effectively improved liver function and MELD score up to 1 year but the sustained benefit was not maintained at the end of 3 years, possibly due to ongoing progression of the underlying disease.

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Long-term Outcomes of Autologous Peripheral Blood Stem Cell Transplantation in Patients With Cirrhosis

Cited by 10 publications

References 42 publications

Stem cell-based therapy for human diseases

Stem cell-based therapy for human diseases

Mesenchymal Stem Cell Therapy in Decompensated Liver Cirrhosis: A Long-Term Follow-up Analysis of the Randomized Controlled Clinical Trial

Long-term Outcome of Autologous Hematopoietic Stem Cell Infusion in Cirrhosis: Waning Effect over Time

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