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Mesenchymal Stem Cells for Treatment and Prevention of Graft-Versus-Host Disease and Graft Failure After Hematopoietic Stem Cell Transplantation and Future Challenges

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Mesenchymal Stem Cell Therapy

Part of the book series: Stem Cell Biology and Regenerative Medicine ((STEMCELL))

Abstract

Graft-versus-host disease (GVHD) is a cause of morbidity and mortality after allogeneic hematopoietic stem cell transplantation (HSCT). The rationale to use mesenchymal stem cells (MSCs) to prevent and treat GVHD and graft failure is due to the ability of MSCs to suppress alloantigen-induced T-cells in vitro. This effect was seen despite HLA-incompatibility between MSC and stimulatory or alloreactive cells in vitro, enabling the potential use of third party MSCs in the clinic. Because MSCs home to target organs of tissue toxicity and have low immunogenicity, they may be important in regenerative medicine, for instance in the treatment of acute GVHD. Clinically, MSCs were found to completely reverse severe acute GVHD in approximately 50% of the patients with steroid-refractory GVHD. In addition, MSCs interfere with coagulation and were found to have a positive effect on hemorrhagic cystitis and were able to stop major hemorrhages in HSCT patients. MSCs produce hematopoietic growth factors and have been used clinically to support hematopoiesis and to treat graft failure. Future related areas of research include prospective randomized clinical trials, determining optimum cell source and dose, identifying the best route of infusion and defining the appropriate number of passages for the MSCs to be used for therapeutic applications.

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Authors and Affiliations

  1. Center for Allogeneic Stem Cell Transplantation and Division of Clinical Immunology, Karolinska Institutet, Karolinska University Hospital, Huddinge, Stockholm, Sweden

    Olle Ringdén M.D., Ph.D.

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  1. Olle Ringdén M.D., Ph.D.
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Correspondence to Olle Ringdén M.D., Ph.D. .

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  1. Cellular Dynamics International, Inc., Science Drive 525, Madison, 53711, Wisconsin, USA

    Lucas G. Chase

  2. , Stem Cells and Regenerative Medicine, Life Technologies, Executive Way 7335, Frederick, 21704, Maryland, USA

    Mohan C. Vemuri

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Ringdén, O. (2013). Mesenchymal Stem Cells for Treatment and Prevention of Graft-Versus-Host Disease and Graft Failure After Hematopoietic Stem Cell Transplantation and Future Challenges. In: Chase, L., Vemuri, M. (eds) Mesenchymal Stem Cell Therapy. Stem Cell Biology and Regenerative Medicine. Humana Press, Totowa, NJ. https://doi.org/10.1007/978-1-62703-200-1_10

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