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Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease

Severe acute graft‐versus‐host disease (GVHD) is a life‐threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT). The placenta protects the fetus from the mother's immune system. We evaluated placenta‐derived decidua stromal cells (DSCs), which differ from bone m...

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Autores principales: Ringden, Olle, Baygan, Arjang, Remberger, Mats, Gustafsson, Britt, Winiarski, Jacek, Khoein, Bita, Moll, Guido, Klingspor, Lena, Westgren, Magnus, Sadeghi, Behnam
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866941/
https://www.ncbi.nlm.nih.gov/pubmed/29533533
http://dx.doi.org/10.1002/sctm.17-0167
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author Ringden, Olle
Baygan, Arjang
Remberger, Mats
Gustafsson, Britt
Winiarski, Jacek
Khoein, Bita
Moll, Guido
Klingspor, Lena
Westgren, Magnus
Sadeghi, Behnam
author_facet Ringden, Olle
Baygan, Arjang
Remberger, Mats
Gustafsson, Britt
Winiarski, Jacek
Khoein, Bita
Moll, Guido
Klingspor, Lena
Westgren, Magnus
Sadeghi, Behnam
author_sort Ringden, Olle
collection PubMed
description Severe acute graft‐versus‐host disease (GVHD) is a life‐threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT). The placenta protects the fetus from the mother's immune system. We evaluated placenta‐derived decidua stromal cells (DSCs), which differ from bone marrow mesenchymal stromal cells (BM‐MSCs), as a treatment for severe acute GVHD. DSCs were obtained from term placentas. The DSCs were given to 38 patients with severe acute GVHD; 25 were steroid refractory (SR). DSCs were thawed and infused in buffer supplemented with either 10% AB plasma (group 1, n = 17), or 5% albumin (group 2, n = 21). The viability of cells was higher when thawed in albumin rather than AB plasma (p < .001). Group 1 received a higher cell dose (p < .001), cells of lower passage number (p < .001), and fewer infusions (p = .002) than group 2. The GVHD response (no/partial/complete) was 7/5/5 in group 1 and 0/10/11 in group 2 (p = .01). One‐year survival in the two groups was 47% (95% confidence interval [CI] 23–68) and 76% (95% CI 51–89), respectively (p = .016). For the SR patients, 1‐year survival was 73% (95% CI 37–90) in SR group 2 (n = 11), which was better than 31% (95% CI 11–54) in SR group 1 (n = 13; p = .02), 20% (95% CI 5–42) in BM‐MSC treated (n = 15; p = .0015), and 3% (95% CI 0–14) in historic controls (n = 32; p < .001). DSCs are a promising new treatment for severe acute GVHD. Prospective randomized trials are needed for evaluation of efficacy. (Clinical trial NCT‐02172937.) stem cells translational medicine 2018;7:325–332
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spelling pubmed-58669412018-03-28 Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease Ringden, Olle Baygan, Arjang Remberger, Mats Gustafsson, Britt Winiarski, Jacek Khoein, Bita Moll, Guido Klingspor, Lena Westgren, Magnus Sadeghi, Behnam Stem Cells Transl Med Human Clinical Article Severe acute graft‐versus‐host disease (GVHD) is a life‐threatening complication after allogeneic hematopoietic stem cell transplantation (HSCT). The placenta protects the fetus from the mother's immune system. We evaluated placenta‐derived decidua stromal cells (DSCs), which differ from bone marrow mesenchymal stromal cells (BM‐MSCs), as a treatment for severe acute GVHD. DSCs were obtained from term placentas. The DSCs were given to 38 patients with severe acute GVHD; 25 were steroid refractory (SR). DSCs were thawed and infused in buffer supplemented with either 10% AB plasma (group 1, n = 17), or 5% albumin (group 2, n = 21). The viability of cells was higher when thawed in albumin rather than AB plasma (p < .001). Group 1 received a higher cell dose (p < .001), cells of lower passage number (p < .001), and fewer infusions (p = .002) than group 2. The GVHD response (no/partial/complete) was 7/5/5 in group 1 and 0/10/11 in group 2 (p = .01). One‐year survival in the two groups was 47% (95% confidence interval [CI] 23–68) and 76% (95% CI 51–89), respectively (p = .016). For the SR patients, 1‐year survival was 73% (95% CI 37–90) in SR group 2 (n = 11), which was better than 31% (95% CI 11–54) in SR group 1 (n = 13; p = .02), 20% (95% CI 5–42) in BM‐MSC treated (n = 15; p = .0015), and 3% (95% CI 0–14) in historic controls (n = 32; p < .001). DSCs are a promising new treatment for severe acute GVHD. Prospective randomized trials are needed for evaluation of efficacy. (Clinical trial NCT‐02172937.) stem cells translational medicine 2018;7:325–332 John Wiley and Sons Inc. 2018-03-13 /pmc/articles/PMC5866941/ /pubmed/29533533 http://dx.doi.org/10.1002/sctm.17-0167 Text en © 2018 The Authors Stem Cells Translational Medicine published by Wiley Periodicals, Inc. on behalf of AlphaMed Press This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Human Clinical Article
Ringden, Olle
Baygan, Arjang
Remberger, Mats
Gustafsson, Britt
Winiarski, Jacek
Khoein, Bita
Moll, Guido
Klingspor, Lena
Westgren, Magnus
Sadeghi, Behnam
Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease
title Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease
title_full Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease
title_fullStr Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease
title_full_unstemmed Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease
title_short Placenta‐Derived Decidua Stromal Cells for Treatment of Severe Acute Graft‐Versus‐Host Disease
title_sort placenta‐derived decidua stromal cells for treatment of severe acute graft‐versus‐host disease
topic Human Clinical Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5866941/
https://www.ncbi.nlm.nih.gov/pubmed/29533533
http://dx.doi.org/10.1002/sctm.17-0167
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