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Access through your institution Buy or subscribe Severe graft-versus-host disease (GVHD) is a lethal complication of allogeneic hematopoietic stem cell transplantation (ASCT), and a number
of approaches are therefore being evaluated.1, 2, 3, 4, 5 Recently, Le Blanc _et al._6 reported a case of grade IV therapy-resistant acute GVHD of the gut and liver that showed rapid
improvement after infusion of mesenchymal stem cells (MSCs). We here report a pilot study using human adipose tissue-derived MSC (AMSC) to treat severe acute GVHD after ASCT. A 38-year-old
female with acute lymphocytic leukemia in second remission received a transplant of hematopoietic stem cells (HSCs) from a human lymphocyte antigen (HLA)-identical unrelated female donor
after conditioning with Ara-C (4 g/m2/day) intravenously (i.v.) on days −10 to −9; busulfan (4 mg/kg/day) orally on days −8 to −6; cyclophosphamide (1.8 g/m2/day) i.v. on days −5 to −4;
Me-CCNU (250 mg/m2) orally once on day −3. Immunosuppression included ATG (thymoglobulin, 2.5 mg/kg/day; Sang Stat, Lyon, France) i.v. for 4 consecutive days, on days −5 to −2 during the
conditioning, followed by a combination of cyclosporine A (CsA), a short course of mycophenolate mofetil (MMF) and four doses of methotrexate (MTX). On day +21, the patient developed a
maculopapular rash of the thorax and back that progressed despite treatment with prednisolone (2 mg/kg/day). On day +38, the patient developed severe diarrhea (>1200 ml/day) and abdominal
pain requiring morphine, and then she stopped eating and was treated with total parenteral nutrition (TPN). Colonoscopy showed moderate-to-severe acute GVHD. The serum total bilirubin level
exceeded 230 _μ_mol/l, and serum alanine aminotransferase (ALT) concentration was higher than 400 U/l. Extracorporeal psoralen-enhanced UVA light treatment (three times per week) was tried
for 6 weeks. Methylprednisolone (500 mg/day), infliximab (10 mg/kg) and daclizumab (1 mg/kg) were ineffective. MMF, tacrolimus and MTX were also tried. Colonoscopy on day +62 showed grade IV
GVHD. In conclusion, this patient seemed to be unresponsive to all types of immunosuppression. At the same time, she was treated for repeated bacterial, viral and invasive fungal
infections. This is a preview of subscription content, access via your institution ACCESS OPTIONS Access through your institution Subscribe to this journal Receive 12 print issues and online
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are calculated during checkout ADDITIONAL ACCESS OPTIONS: * Log in * Learn about institutional subscriptions * Read our FAQs * Contact customer support REFERENCES * Bianco JA, Higano C,
Singer J, Appelbaum FR, McDonald GB . The somatostatin analog octreotide in the management of the secretory diarrhea of the acute intestinal graft-versus-host disease in a patient after bone
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references AUTHOR INFORMATION AUTHORS AND AFFILIATIONS * Henan Tumor Research Institute, Henan Tumor Hospital, Henan Medical School, Henan University, Zhengzhou, China B Fang & Y P Song
* Institute of Haematology and Blood Diseases Hospital, Center of Excellence in Tissue Engineering, Chinese Academy of Medical Sciences, Tianjin, China L M liao, Q Han & R C Zhao Authors
* B Fang View author publications You can also search for this author inPubMed Google Scholar * Y P Song View author publications You can also search for this author inPubMed Google Scholar
* L M liao View author publications You can also search for this author inPubMed Google Scholar * Q Han View author publications You can also search for this author inPubMed Google Scholar
* R C Zhao View author publications You can also search for this author inPubMed Google Scholar RIGHTS AND PERMISSIONS Reprints and permissions ABOUT THIS ARTICLE CITE THIS ARTICLE Fang, B.,
Song, Y., liao, L. _et al._ Treatment of severe therapy-resistant acute graft-versus-host disease with human adipose tissue-derived mesenchymal stem cells. _Bone Marrow Transplant_ 38,
389–390 (2006). https://doi.org/10.1038/sj.bmt.1705457 Download citation * Published: 31 July 2006 * Issue Date: 01 September 2006 * DOI: https://doi.org/10.1038/sj.bmt.1705457 SHARE THIS
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