Multicenter randomized trial of mesenchymal stem cells for prophylaxis of cGVHD after haploidentical HSCT

Chronic graft-versus-host disease (cGVHD) limits the long-term benefit of haploidentical hematopoietic stem cell transplant (haplo-HSCT). A randomized clinical trial at five centers in China evaluated repeated infusions of umbilical cord mesenchymal stem cells (MSCs) during the early stage after haplo-HSCT to prevent cGVHD. Patients were randomized 1:1 to 4 times infusion of MSCs form day 45 after haplo-HSCT every two weeks in addition to standard prophykaxis (MSC group) or standard prophylaxis alone (control group). The figure shows that the cumulative incidence of severe cGVHD an of cGVHD was significantly lower in the MSC group compared with the control group, while no difference was seen in cumulative incidence of leukemia relapse. The cumulative incidence of acute GVHD also was lower in the MSC group than in the control group. The authors conclude that among patients undergoing haplo-HSCT, early repeated infusions of MSCs decreased the incidence and severity of cGVHD.