B1 Other refereed article (e.g., editorial, letter, comment) in a scientific journal
The use of MSCs in steroid-refractory acute GvHD in Europe: a survey from the EBMT cellular therapy & immunobiology working party
Authors: Daenen, L. G. M.; van der Wagen, L. E.; Bonneville, E. F.; Lopez-Corral, L.; Bukauskas, A.; Bornhaeuser, M.; Beguin, Y.; Itälä-Remes, M.; Hoogenboom, J. D.; de Wreede, L. C.; Malard, F.; Chabannon, C.; Dazzi, F.; Ruggeri, A.; Kuball, J.
Publisher: Springer Science and Business Media LLC
Publishing place: LONDON
Publication year: 2025
Journal: Bone Marrow Transplantation
Journal name in source: Bone Marrow Transplantation
Journal acronym: BONE MARROW TRANSPL
Volume: 60
First page : 708
Last page: 714
Number of pages: 7
ISSN: 0268-3369
eISSN: 1476-5365
DOI: https://doi.org/10.1038/s41409-025-02531-3
Web address : https://doi.org/10.1038/s41409-025-02531-3
Acute graft-versus-host disease (aGvHD) remains a significant complication of allogeneic hematopoietic cell transplantation, with 40% of patients failing to respond to high-dose steroids. Ruxolitinib has become the standard treatment for steroid-refractory aGvHD (SR-GvHD), but its failure in approximately one-third of cases highlights the need for alternative therapies. Mesenchymal stromal cells (MSCs), known for their immunomodulatory properties, are suggested as a treatment option, but their role in SR-GvHD remains unclear. To better understand MSC therapy outcomes, the EBMT Cellular Therapy & Immunobiology Working Party conducted a survey of centers treating >20 SR-GvHD patients with MSCs between 2007 and 2020. Data from 313 patients were analyzed, revealing a 44.5% overall response rate at day 28. Responders at day 7 had a higher likelihood of maintaining responses by day 28. Using a landmark analysis, the overall survival at 12 months, conditional on being alive at day 28, was 39.2%. Survival at 12 months was 48.6% for responders, compared to 24.4% for non-responders. Despite manufacturing variabilities, MSCs produced by academic pharma appear effective in SR-GvHD, offering a viable treatment alternative for heavily pretreated patients. These findings support further investigation of MSCs to establish standardized protocols and validate their efficacy as third-line therapy for SR-GvHD.
