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Donor-derived marrow mesenchymal stromal cell co-transplantation following a haploidentical hematopoietic stem cell transplantation trail to treat severe aplastic anemia in children

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Abstract

Haploidentical hematopoietic stem cell transplantation (haplo-HSCT) is associated with an increased risk of graft failure and severe graft-versus-host disease (GVHD). Recent studies have shown that mesenchymal stromal cells (MSCs) display potent immunosuppressive effects and can support normal hematopoiesis. In a multi-center trial, we co-transplanted culture-expanded donor-derived bone marrow MSCs (BM-MSCs) into 35 children with severe aplastic anemia (SAA) undergoing haplo-HSCT. All 35 patients (100%) achieved hematopoietic reconstitution and showed sustained full donor chimerism. The median time for myeloid engraftment was 14 days (range 10–22 days), while that for platelet engraftment was 18 days (range 9–36 days). The incidence of grade II–IV acute GVHD and chronic GVHD was 25.71 and 22.86%, respectively. The overall survival rate was 85.71% with a median of 22 months (range 3.5–37 months). The combined transplantation of haploidentical HSCs and BM-MSCs into children with SAA without an HLA-identical sibling donor is relatively safe and may represent an effective new therapy to improve survival rates and reduce the risk of graft failure.

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Funding

This research is supported by the National Natural Science Foundation of China (grant 81430088) and the Natural Science Foundation of Heilongjiang Province (grant JJ2017QN0760), China.

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Author notes

  1. Z.-K. Wang and H.-J. Yu contributed equally to this work.

Authors and Affiliations

  1. Central Laboratory of Hematology and Oncology, The First Affiliated Clinical Hospital of Harbin Medical University, Harbin, China

    Z. -K. Wang, F. -L. Cao, Z. -Y. Liu, W. -J. Feng, X. -L. Liu & Y. -Y. Yu

  2. Department of Hematology, The First Affiliated Clinical Hospital of Harbin Medical University, Harbin, China

    H. -J. Yu, L. -M. Li & J. Zhou

  3. Department of Hematology, Guangzhou General Hospital of Guangzhou Military Command, Guangzhou, China

    Z. -H. Liu & Y. Xiao

  4. Stem Cell Translational Medicine Center, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China

    Y. Xiao

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  1. Z. -K. Wang
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  2. H. -J. Yu
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  3. F. -L. Cao
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  4. Z. -H. Liu
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  8. Y. -Y. Yu
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  9. Y. Xiao
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  10. L. -M. Li
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  11. J. Zhou
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Corresponding authors

Correspondence to Y. Xiao, L. -M. Li or J. Zhou.

Ethics declarations

The haplo-HSCT with BM-MSC protocol for the treatment of SAA was approved by the ethics committee.

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The authors declare that they have no conflict of interest.

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Wang, Z.K., Yu, H.J., Cao, F.L. et al. Donor-derived marrow mesenchymal stromal cell co-transplantation following a haploidentical hematopoietic stem cell transplantation trail to treat severe aplastic anemia in children. Ann Hematol 98, 473–479 (2019). https://doi.org/10.1007/s00277-018-3523-2

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  • DOI: https://doi.org/10.1007/s00277-018-3523-2

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