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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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Submitted April 24, 2007
Accepted July 11, 2007
Co-transplantation 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 Ball*, Maria Ester Bernardo, Helene Roelofs, Arjan Lankester, Angela Cometa, R. Maarten Egeler, Franco Locatelli, and Willem E Fibbe
Department of Pediatric Stem Cell Transplantation, Leiden University Medical Center, Leiden, Netherlands
Department of Pediatric Hematology/Oncology, Fondazione IRCCS Policlinico S. Matteo, University of Pavia, Pavia, Italy
Department Immunohematology & Stem Cell Research, Leiden University Medical Center, Leiden, Netherlands
* Corresponding author; email: l.m.ball{at}lumc.nl.
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 co-transplanted 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 historical controls, all patients given MSCs showed sustained hematopoietic engraftment, without any adverse reaction. In particular, children given MSCs did not experience more infections as compared to 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 HSCT recipients.
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