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In Vitro Mesenchymal Progenitor Cell Expansion is a Predictor of Transplant-related Mortality and acute GvHD III-IV After Bone Marrow Transplantation in Univariate Analysis

A Large Single-Center Experience

Berger, Massimo, MD, PhD*; Mareschi, Katia, BSc*,†; Castiglia, Sara, BSc*; Rustichelli, Deborah, BSc*; Mandese, Alessandra, BSc*; Migliore, Enrica, PhD; Fagioli, Franca, MD*

Journal of Pediatric Hematology/Oncology: January 2019 - Volume 41 - Issue 1 - p 42–46
doi: 10.1097/MPH.0000000000001281
Original Articles

Mesenchymal stromal cells (MSCs) are multipotent stem cells able to differentiate into mesenchymal origin tissue and support the growth of hematopoietic stem cells. In order to understand the role of MSCs infused in bone marrow grafts, 53 consecutive patients were analyzed for engraftment, acute and chronic graft-versus-host disease (GvHD), transplant-related mortality (TRM), relapse incidence, and overall survival. The MSC content was measured as MSC expansion at the second passage. When in vitro–expanded MSC (cumulative population doubling at second passage, cPDp2) values were stratified according to the median value (2.2-fold increase), the univariate analysis showed a significant difference in TRM (23% vs. 3.8%, P=0.05.) and in acute GvHD III-IV incidence (12% vs. 4%, P=0.04), while the multivariate analysis did not confirm its independent role. No clinical parameters in donors and recipients were identified as predictors of cPDp2 expansion. Our study suggests a role for short-term ex vivo–expanded MSCs in reduced aGVHD III-IV incidence and TRM in univariate analysis. A multicenter, larger study is warranted to confirm these data.

*Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children’s Hospital

Public Health and Paediatrics Department, University of Turin

Cancer Epidemiology Unit, City of Science and Health of Turin University-Hospital and Center for Cancer Prevention (CPO), Turin, Italy

M.B. and K.M. contributed equally to the work.

The authors declare no conflict of interest.

Reprints: Massimo Berger, MD, PhD, Paediatric Onco-Haematology, Stem Cell Transplantation and Cellular Therapy Division, City of Science and Health of Turin, Regina Margherita Children’s Hospital, Piazza Polonia 94, 10126 Turin, Italy (e-mail: massimo.berger@unito.it).

Received March 7, 2018

Accepted July 9, 2018

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