A Pilot Study of A Novel Therapy Using Mesenchymal Stromal Cells for Steroid-Resistant Graft-Versus-Host Disease

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Mesenchymal stromal cells (MSCs) have been reported to have immunomodulatory effects and ameliorate severe graft-versus-host disease (GVHD) after allogeneic stem cell transplantation (SCT). We have conducted a pilot study using human MSCs for the treatment of steroid-resistant GVHD. Between January 2006 and December 2010, 10 patients (7 males and 3 females) with a median age of 37.9 years (range: 23-65 years) who had steroid-resistant GVHD were enrolled in this study. MSCs were isolated from bone marrow of the patient’s relatives. Among these 10 patients, three were treated with MSCs.The other seven did not receive MSC treatment because of an improvement in GVHD due to the addition of immunosuppressants including methylprednisolone, spontaneous GVHD regression, or early death. Of the three patients treated with MSCs, one showed an improvement in his intestinal GVHD, another showed no change in his intestinal GVHD and third had his dose of prednisolone successfully decreased without progression of his intestinal GVHD. No immediate adverse reactions associated with MSC infusions were observed. Since the present study was limited to a small number of patients, it is difficult to evaluate the efficacy of MSCs for steroid-resistant GVHD. Further investigations are needed to establish the clinical application of MSCs for steroid-resistant GVHD.

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