Emese Molnar* 1, Aniko Barta2, Arpad Batai2, Zoltan Csukly2, Laszlo Gopcsa2, Gabor Tatai2, Lilla Lengyel2, Tamas Masszi3 , Gabor Mikala2, Melinda Paksi2, Marienn Réti2, Eva Torbagyi2, Hajnalka Andrikovics4, Halvard Bönig5, Peter Bader5,
1Department of Serology, Hungarian National Blood Transfusion Service, 2Department of Hematology and HSCT ,
Central Hospital of Sothern Pest, 33rd Department Of Internal Medicine, Semmelweis University, 4Laboratory of Molecular Diagnostics, Central Hospital of Sothern Pest, Budapest, Hungary, 5Division for Stem Cell Transplantation and Immunology, University Hospital Frankfurt/Main, Frankfurt, Germany
Steroid-refractory graft-versus-host disease (GvHD) is a serious complication of allogeneic hematopoietic stem cell transplantation (HSCT) with limited treatment options. We evaluated the efficacy of mesenchymal stem cell (MSC) transfusions in GvHD refractory to conventional treatments. Patients with steroid-resistant GvHD were treated with novel MSC product (derived from 8 bone marrow donors, “MSC-FFM” generated by University of Frankfurt am Main, Germany) 4 times weekly at a dose of 1 million cells/kg. Twelve patients received 13 cycles (4 doses/cycle). The median age was 47 (19-56) years with a male/female ratio of 1:2. Nine patients had allo-HSCT with matched unrelated donors, three with HLA-identic relatives. GvHD was observed on median 63rd (7-455) day after HSCT. The involved organs were skin (2), gut (4), skin and gut combined (7) and lung in 3 cases. The median time of MSC’s first infusion was 274 (114-1981) days after HSCT and 165 (19-1974) days after GvHD onset. Four of the 13 MSC-cycles (30.8%) led to complete and 7 (53.8%) resulted in partial remission. GvHD NIH stage score before MSC infusions was 3 in all cases, which decreased to a median of 1 after treatment. The overall survival on the 180th day after GvHD onset was 75%. Red blood cell concentrate requirement was reduced from an average of 12.83 to 8.92 (30.5%) and platelet concentrate need from 107.17 to 50.75 (52.6% reduction) after MSC treatment. In summary, MSC-FFM product is an effective, promising alternative treatment for GvHD with 83% response rate.
Doctoral School: Clinical Medicine
Program: Clinical Haematology
Supervisor: Hajnalka Andrikovics, MD, PhD