Single intra-arterial injection of mesenchymal stromal cells for treatment of steroid-refractory acute graft-versus-host disease: a pilot study

Arima, Nobuyoshi; Nakamura, Fumiaki; Fukunaga, Akiko; Hirata, Hirokazu; Machida, Hiroko; Kouno, Shigene; Ohgushi, Hajime

doi:10.3109/14653240903390795

Cited by 56 publications

(41 citation statements)

References 12 publications

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“…We also left the treatment option of a second HSCT or mesenchymal stem cell therapy as a final option, because these treatments increase the risk of infection [8]. Etoposide was used as the initial intervention.…”

Section: Discussionmentioning

confidence: 99%

Successful treatment with combined chemotherapy of two adult cases of hemophagocytic lymphohistiocytosis in recipients of umbilical cord blood cell transplantation

et al. 2011

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Hemophagocytic lymphohistiocytosis (HLH), which occurs during the early period following allogeneic hematopoietic stem cell transplantation (HSCT), is often difficult to diagnose. It is characterized by severe clinical manifestations and high mortality. Despite current therapeutic approaches, outcomes remain poor. Here, we summarize the cases of two patients who experienced engraftment failure and subsequently developed hematopoietic stem cell transplantation-hemophagocytic lymphohistiocytosis (HSCT-HLH). Both patients had high-risk hematological malignancies for which they underwent umbilical cord blood transplantation (UCBT) at our institution. Based on the presence of massive hemophagocytosis in their bone marrow specimens and the results of chimerism analysis, diagnosis of HSCT-HLH was made in both cases. A single infusion of low-dose etoposide was administered immediately to each patient. Four days after the injection, therapeutic efficacy was evaluated. As both cases showed an insufficient response to etoposide, we added vincristine and a medium dose of prednisolone. Clinical symptoms rapidly improved and stable engraftments were observed within a week. The first and second patients were alive 1008 and 232 days after UCBT, respectively. The combined use of low-dose etoposide and vincristine plus prednisolone appears to be a promising treatment option for HSCT-HLH, without serious adverse side effects.

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Section: Discussionmentioning

confidence: 99%

Successful treatment with combined chemotherapy of two adult cases of hemophagocytic lymphohistiocytosis in recipients of umbilical cord blood cell transplantation

et al. 2011

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“…A summary of different clinical trials of MSC therapy for GvHD is provided in Table 2. Overall, these studies have shown that MSC infusion appears to be a safe treatment option for GvHD, not associated with any long-term risk [60,61,62,63,64,65,66,67,68,69,70,71,72,73,74]. Although different studies have confirmed the clinical benefits in patients with steroid resistant grade II–IV aGvHD or cGvHD, other randomized controlled trials are ongoing to assess the definitive efficacy and safety of this treatment modality.…”

Section: Clinical Applications Of Mscs In Allo-hsct and Gvhdmentioning

confidence: 99%

Mesenchymal Stem Cell Derived Extracellular Vesicles: A Role in Hematopoietic Transplantation?

Luca

Trino

Laurenzana

et al. 2017

IJMS

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Mesenchymal stem cells (MSCs) are a heterogeneous cellular population containing different progenitors able to repair tissues, support hematopoiesis, and modulate immune and inflammatory responses. Several clinical trials have used MSCs in allogeneic hematopoietic stem cell transplantation (allo-HSCT) to prevent hematopoietic stem cell (HSC) engraftment failure, reduce aplasia post chemotherapy, and to control graft versus host disease (GvHD). The efficacy of MSCs is linked to their immune suppressive and anti-inflammatory properties primarily due to the release of soluble factors. Recent studies indicate that most of these effects are mediated by extracellular vesicles (EVs). MSC-EVs have therefore therapeutic effects in regenerative medicine, tumor inhibition, and immune-regulation. MSC-EVs may offer specific advantages for patient safety, such as lower propensity to trigger innate and adaptive immune responses. It has been also shown that MSC-EVs can prevent or treat acute-GvHD by modulating the immune-response and, combined with HSCs, may contribute to the hematopoietic microenvironment reconstitution. Finally, MSC-EVs may provide a new potential therapeutic option (e.g., transplantation, gene therapy) for different diseases, particularly hematological malignancies. In this review, we will describe MSC and MSC-EVs role in improving allo-HSCT procedures and in treating GvHD.

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“…Nonetheless, stem-cell therapy has been in use since the 1990s in other fields for conditions such as acute and chronic graft-versus-host-disease to enhance engraftment in patients receiving allogeneic hematopoietic stem cell transplantation [21]. The anti-inflammatory, restorative, and immunomodulatory qualities of stem cells are currently being exploited clinically to treat hematologic diseases [222324]; malignancies [25]; cardiovascular disease [26]; neurologic diseases such as amyotrophic lateral sclerosis [272829], Parkinson disease [30], and stroke [31]; autoimmune diseases such as multiple sclerosis [3132] and systemic lupus erythematosus [33]; as well as refractory wounds [34], spinal cord injuries [35], and cartilage defects [36]. It makes sense that the field of urology would also benefit from the utilization of this type of approach for acute and chronic urologic illnesses.…”

Section: Role Of Stem Cells In the Treatment Of Erectile Dysfunctionmentioning

confidence: 99%

The Current Status of Stem-Cell Therapy in Erectile Dysfunction: A Review

Reed‐Maldonado

Lue

2016

World J Mens Health

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Stem cells are undifferentiated cells that are capable of renewal and repair of tissue due to their capacity for division and differentiation. The purpose of this review is to describe recent advances in the use of stem cell (SC) therapy for male erectile dysfunction (ED). We performed a MEDLINE database search of all relevant articles regarding the use of SCs for ED. We present a concise summary of the scientific principles behind the usage of SC for ED. We discuss the different types of SCs, delivery methods, current pre-clinical literature, and published clinical trials. Four clinical trials employing SC for ED have been published. These articles are summarized in this review. All four report improvements in ED after SC therapy. SC therapy remains under investigation for the treatment of ED. It is reassuring that clinical trials thus far have reported positive effects on erectile function and few adverse events. Safety and methodical concerns about SC acquisition, preparation and delivery remain and require continued investigation prior to wide-spread application of these methods.

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Single intra-arterial injection of mesenchymal stromal cells for treatment of steroid-refractory acute graft-versus-host disease: a pilot study

Cited by 56 publications

References 12 publications

Successful treatment with combined chemotherapy of two adult cases of hemophagocytic lymphohistiocytosis in recipients of umbilical cord blood cell transplantation

Successful treatment with combined chemotherapy of two adult cases of hemophagocytic lymphohistiocytosis in recipients of umbilical cord blood cell transplantation

Mesenchymal Stem Cell Derived Extracellular Vesicles: A Role in Hematopoietic Transplantation?

The Current Status of Stem-Cell Therapy in Erectile Dysfunction: A Review

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