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Blood, 1 October 2007, Vol. 110, No. 7, pp. 2764-2767.
Prepublished online as a Blood First Edition Paper on July 16, 2007; DOI 10.1182/blood-2007-04-087056.
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TRANSPLANTATION
Brief Report
Cotransplantation of ex vivo–expanded mesenchymal stem cells accelerates lymphocyte recovery and may reduce the risk of graft failure in haploidentical hematopoietic stem-cell transplantation
Lynne M. Ball1,
Maria Ester Bernardo2,
Helene Roelofs3,
Arjan Lankester1,
Angela Cometa2,
R. Maarten Egeler1,
Franco Locatelli2, and
Willem E. Fibbe3
1 Department of Pediatric Stem Cell Transplantation, Leiden University Medical Centre, Leiden, the Netherlands;
2 Pediatric Hematology/Oncology, Fondazione Istituti di Ricovero e Cura a Catattere Scientifico (IRCCS) Policlinico San Matteo, University of Pavia, Pavia, Italy; and
3 Immunohematology and Stem Cell Research, Leiden University Medical Centre, Leiden, the Netherlands
Haploidentical hematopoietic stem-cell transplantation (HSCT) is associated with an increased risk of graft failure. Adult bone marrow–derived mesenchymal stromal cells (MSCs) have been shown to support in vivo normal hematopoiesis and to display potent immune suppressive effects. We cotransplanted donor MSCs in 14 children undergoing transplantation of HLA-disparate CD34+ cells from a relative. While we observed a graft failure rate of 15% in 47 historic controls, all patients given MSCs showed sustained hematopoietic engraftment without any adverse reaction. In particular, children given MSCs did not experience more infections compared with controls. These data suggest that MSCs, possibly thanks to their potent immunosuppressive effect on alloreactive host T lymphocytes escaping the preparative regimen, reduce the risk of graft failure in haploidentical HSC transplant recipients.
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