Mesenchymal stromal cells for treatment of steroid-refractory GvHD: a review of the literature and two pediatric cases.
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Mesenchymal stromal cells for treatment of steroid-refractory GvHD: a review of the literature and two pediatric cases. / Wernicke, Caroline M; Grunewald, Thomas G P; Juenger, Hendrik; Kuci, Selim; Kuci, Zyrafete; Koehl, Ulrike; Müller, Ingo; Doering, Michaela; Peters, Christina; Lawitschka, Anita; Kolb, Hans-Jochem; Bader, Peter; Burdach, Stefan; von Luettichau, Irene.
In: Int Arch Med, Vol. 4, No. 1, 1, 2011, p. 27.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Mesenchymal stromal cells for treatment of steroid-refractory GvHD: a review of the literature and two pediatric cases.
AU - Wernicke, Caroline M
AU - Grunewald, Thomas G P
AU - Juenger, Hendrik
AU - Kuci, Selim
AU - Kuci, Zyrafete
AU - Koehl, Ulrike
AU - Müller, Ingo
AU - Doering, Michaela
AU - Peters, Christina
AU - Lawitschka, Anita
AU - Kolb, Hans-Jochem
AU - Bader, Peter
AU - Burdach, Stefan
AU - von Luettichau, Irene
PY - 2011
Y1 - 2011
N2 - Severe acute graft versus host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. Human mesenchymal stromal cells (MSCs) play an important role in endogenous tissue repair and possess strong immune-modulatory properties making them a promising tool for the treatment of steroid-refractory GvHD. To date, a few reports exist on the use of MSCs in treatment of GvHD in children indicating that children tend to respond better than adults, albeit with heterogeneous results.We here present a review of the literature and the clinical course of two instructive pediatric patients with acute steroid-refractory GvHD after haploidentical stem cell transplantation, which exemplify the beneficial effects of third-party transplanted MSCs in treatment of acute steroid-refractory GvHD. Moreover, we provide a meta-analysis of clinical studies addressing the outcome of patients with steroid-refractory GvHD and treatment with MSCs in adults and in children (n = 183; 122 adults, 61 children). Our meta-analysis demonstrates that the overall response-rate is high (73.8%) and confirms, for the first time, that children indeed respond better to treatment of GvHD with MSCs than adults (complete response 57.4% vs. 45.1%, respectively).These data emphasize the significance of this therapeutic approach especially in children and indicate that future prospective studies are needed to assess the reasons for the observed differential response-rates in pediatric and adult patients.
AB - Severe acute graft versus host disease (GvHD) is a life-threatening complication after allogeneic hematopoietic stem cell transplantation. Human mesenchymal stromal cells (MSCs) play an important role in endogenous tissue repair and possess strong immune-modulatory properties making them a promising tool for the treatment of steroid-refractory GvHD. To date, a few reports exist on the use of MSCs in treatment of GvHD in children indicating that children tend to respond better than adults, albeit with heterogeneous results.We here present a review of the literature and the clinical course of two instructive pediatric patients with acute steroid-refractory GvHD after haploidentical stem cell transplantation, which exemplify the beneficial effects of third-party transplanted MSCs in treatment of acute steroid-refractory GvHD. Moreover, we provide a meta-analysis of clinical studies addressing the outcome of patients with steroid-refractory GvHD and treatment with MSCs in adults and in children (n = 183; 122 adults, 61 children). Our meta-analysis demonstrates that the overall response-rate is high (73.8%) and confirms, for the first time, that children indeed respond better to treatment of GvHD with MSCs than adults (complete response 57.4% vs. 45.1%, respectively).These data emphasize the significance of this therapeutic approach especially in children and indicate that future prospective studies are needed to assess the reasons for the observed differential response-rates in pediatric and adult patients.
M3 - SCORING: Journal article
VL - 4
SP - 27
IS - 1
M1 - 1
ER -