Feasibility of co-transplantation of umbilical cord blood and third-party mesenchymal stromal cells after (non)myeloablative conditioning in patients with hematological malignancies. - 17/08/24

Doi : 10.1016/j.retram.2024.103466

Simon Planken ¹, Ann De Becker ^1,^⁎ , Tessa Kerre ², Helene Schoemans ³, Frédéric Baron ⁴, Carlos Graux ⁵, Ivan Van Riet ¹, Chantal Lechanteur ⁶, Etienne Baudoux ⁶, Rik Schots ^1,^{^{=
These authors contributed equally to the manuscript.}}, Yves Beguin ^4,^{^{=
These authors contributed equally to the manuscript.}}
on behalf of the
Transplant Committee of the Belgian Hematology Society.
¹ Department of Hematology, Vrije Universiteit Brussel (VUB), Universitair Ziekenhuis Brussel (UZ Brussel), Laarbeeklaan 101, 1090 Brussels, Belgium and Research Group Hematology and Immunology, Vrije Universiteit Brussel (VUB), Laarbeeklaan 103, 1090 Brussels, Belgium
² UZ Gent, Department of Hematology – SCT Unit, Ghent, Belgium
³ Department of Hematology, University Hospitals Leuven, Leuven, Belgium and Department of Public Health and Primary Care, ACCENT VV, KU Leuven – University of Leuven, Leuven, Belgium
⁴ CHU Sart-Tilman, Department of Hematology, Liège, Belgium
⁵ CHU UCL Namur - Godinne, Department of Hematology, Yvoir, Belgium
⁶ CHU Sart-Tilman, Laboratory of Cell and Gene Therapy, Liège, Belgium

^⁎Corresponding author: UZ Brussel, Department of Hematology, Laarbeeklaan 101, 1090 Brussel, BelgiumUZ Brussel, Department of HematologyLaarbeeklaan 101Brussel1090Belgium

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Abstract

Umbilical cord blood (UCB) is an alternative source of stem cells for patients lacking a 9/10 or 10/10 HLA identical donor. However, after UCB transplantation, time to engraftment and immune recovery are prolonged, increasing the risk of fatal complications. Mesenchymal stromal cells (MSC) can support hematopoietic engraftment and have immunosuppressive effects.

The primary objective of this phase I/II multicenter study was to determine the feasibility and safety of UCB transplantation with co-infusion of third party MSC, as assessed by treatment related mortality (TRM) at day 100. Secondary objectives were engraftment, immune recovery, occurrence of graft versus host disease (GVHD), infections, disease free survival, relapse incidence and overall survival.

Eleven patients were grafted according to this protocol. Allogeneic transplantation after co-infusion appears feasible with 18% TRM at day 100. Engraftment data show a median time of 16 days to neutrophil and 27 days to platelet recovery, which is shorter than what is usually reported after UCB transplantation. Only 1 episode of acute GVHD was reported.

In conclusion, MSC and UCB co-transplantation is feasible and might help overcome some of the drawbacks of UCB transplantation.

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Keywords : mesenchymal stromal cell, Umbilical cord blood transplantation coinfusion