Successful treatment with placenta-derived decidual stromal cells in a pediatric patient with life-threatening acute gastrointestinal graft-versus-host disease
Corresponding Author
Britt Gustafsson
Department of Clinical Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden
Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
Correspondence
Britt Gustafsson, Department of Clinical Intervention and Technology, CLINTEC, Karolinska Institutet, Dept. of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden.
Email: [email protected]
Search for more papers by this authorPer Frisk
Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden
Search for more papers by this authorAttilla Szakos
Department of Pathology and Cytologi, Karolinska University Hospital, Stockholm, Sweden
Search for more papers by this authorBehnam Sadeghi
Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden
Search for more papers by this authorOlle Ringdén
Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden
Search for more papers by this authorBritt-Marie Frost
Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden
Search for more papers by this authorCorresponding Author
Britt Gustafsson
Department of Clinical Intervention and Technology, CLINTEC, Karolinska Institutet, Stockholm, Sweden
Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
Correspondence
Britt Gustafsson, Department of Clinical Intervention and Technology, CLINTEC, Karolinska Institutet, Dept. of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden.
Email: [email protected]
Search for more papers by this authorPer Frisk
Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden
Search for more papers by this authorAttilla Szakos
Department of Pathology and Cytologi, Karolinska University Hospital, Stockholm, Sweden
Search for more papers by this authorBehnam Sadeghi
Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden
Search for more papers by this authorOlle Ringdén
Department of Laboratory Medicine, Division of Therapeutic Immunology, Karolinska Institutet, Stockholm, Sweden
Search for more papers by this authorBritt-Marie Frost
Department of Women's and Children's Health, Pediatric Oncology, Children's University Hospital, Uppsala, Sweden
Department of Women's and Children's Health, Uppsala University Hospital, Uppsala, Sweden
Search for more papers by this authorAbstract
Severe aGvHD is a life-threatening complication after allogeneic HSCT. The GI tract is considered to play a key role in aGvHD, where the disease process can start and is one of the major target organs. Here, we present a case of a one-year-old child with a life-threatening GI-aGvHD stage IV, post-HSCT, resistant to steroids and MMF for 4 weeks. He was successfully treated with placenta-derived DSC.
REFERENCES
- 1Inamoto Y, Martin PJ, Chai X, et al. Clinical benefit of response in chronic graft-versus-host disease. Biol Blood Marrow Transplant. 2012; 18: 1517-1524.
- 2Reddy P, Ferrara JLM. Mouse models of graft-versus-host disease. StemBook. Cambridge, MA: Harvard Stem Cell Institute; 2008.
- 3Couriel DR, Saliba R, de Lima M, et al. A phase III study of infliximab and corticosteroids for the initial treatment of acute graft-versus-host disease. Biol Blood Marrow Transplant. 2009; 15: 1555-1562.
- 4Bolanos-Meade J, Jacobsohn DA, Margolis J, et al. Pentostatin in steroid-refractory acute graft-versus-host disease. J Clin Oncol. 2005; 23: 2661-2668.
- 5Bacigalupo A. Management of acute graft-versus-host disease. Br J Haematol. 2007; 137: 87-98.
- 6Martin PJ, Schoch G, Fisher L, et al. A retrospective analysis of therapy for acute graft-versus-host disease: secondary treatment. Blood. 1991; 77: 1821-1828.
- 7Ringden O, Nilsson B. Death by graft-versus-host disease associated with HLA mismatch, high recipient age, low marrow cell dose, and splenectomy. Transplantation. 1985; 40: 39-44.
- 8Deeg HJ. How I treat refractory acute GVHD. Blood. 2007; 109: 4119-4126.
- 9Le Blanc K, Rasmusson I, Sundberg B, et al. Treatment of severe acute graft-versus-host disease with third party haploidentical mesenchymal stem cells. Lancet. 2004; 363: 1439-1441.
- 10Ringden O, Uzunel M, Rasmusson I, et al. Mesenchymal stem cells for treatment of therapy-resistant graft-versus-host disease. Transplantation. 2006; 81: 1390-1397.
- 11von Dalowski F, Kramer M, Wermke M, et al. Mesenchymal stromal cells for treatment of acute steroid-refractory graft versus host disease: clinical responses and long-term outcome. Stem Cells. 2016; 34: 357-366.
- 12von Bahr L, Sundberg B, Lonnies L, et al. Long-term complications, immunologic effects, and role of passage for outcome in mesenchymal stromal cell therapy. Biol Blood Marrow Transplant. 2012; 18: 557-564.
- 13Le Blanc K, Frassoni F, Ball L, et al. Mesenchymal stem cells for treatment of steroid-resistant, severe, acute graft-versus-host disease: a phase II study. Lancet. 2008; 371: 1579-1586.
- 14Bernardo ME, Ball LM, Cometa AM, et al. Co-infusion of ex vivo-expanded, parental MSCs prevents life-threatening acute GVHD, but does not reduce the risk of graft failure in pediatric patients undergoing allogeneic umbilical cord blood transplantation. Bone Marrow Transplant. 2011; 46: 200-207.
- 15Hashmi S, Ahmed M, Murad MH, et al. Survival after mesenchymal stromal cell therapy in steroid-refractory acute graft-versus-host disease: systematic review and meta-analysis. Lancet Haematol. 2016; 3: e45-e52.
- 16Karlsson H, Erkers T, Nava S, Ruhm S, Westgren M, Ringden O. Stromal cells from term fetal membrane are highly suppressive in allogeneic settings in vitro. Clin Exp Immunol. 2012; 167: 543-555.
- 17Chang CJ, Yen ML, Chen YC, et al. Placenta-derived multipotent cells exhibit immunosuppressive properties that are enhanced in the presence of interferon-gamma. Stem Cells. 2006; 24: 2466-2477.
- 18Barlow S, Brooke G, Chatterjee K, et al. Comparison of human placenta- and bone marrow-derived multipotent mesenchymal stem cells. Stem Cells Dev. 2008; 17: 1095-1107.
- 19Ringden O, Erkers T, Nava S, et al. Fetal membrane cells for treatment of steroid-refractory acute graft-versus-host disease. Stem Cells. 2013; 31: 592-601.
- 20Ringdén OS M, Erkers T, Nava S, et al. Successful reversal of acute lung injury using placenta-derived decidual stromal cells. J Stem Cell Res Ther. 2014; 4: 244.
- 21Storb R, Thomas ED. Graft-versus-host disease in dog and man: the Seattle experience. Immunol Rev. 1985; 88: 215-238.
- 22Storb R, Gyurkocza B, Storer BE, et al. Graft-versus-host disease and graft-versus-tumor effects after allogeneic hematopoietic cell transplantation. J Clin Oncol. 2013; 31: 1530-1538.
- 23Ringden O, Andstrom EE, Remberger M, Dahllof G, Svahn BM, Tollemar J. Prophylaxis and therapy using liposomal amphotericin B (AmBisome) for invasive fungal infections in children undergoing organ or allogeneic bone-marrow transplantation. Pediatr Transplant. 1997; 1: 124-129.
- 24Parekkadan B, Upadhyay R, Dunham J, et al. Bone marrow stromal cell transplants prevent experimental enterocolitis and require host CD11b+ splenocytes. Gastroenterology. 2011; 140: 966-975.
- 25Erkers T, Nava S, Yosef J, Ringden O, Kaipe H. Decidual stromal cells promote regulatory T cells and suppress alloreactivity in a cell contact-dependent manner. Stem Cells Dev. 2013; 22: 2596-2605.
Citing Literature
