Arthritis & Rheumatism, Volume 60,
October 2009 Abstract Supplement
The 2009 ACR/ARHP Annual Scientific Meeting
Philadelphia October 16-21, 2009.
Allogenic Mesenchymal Stem Cells Transplantation for Patients with Systemic Lupus Erythematosus: One-Year Fellowup
Sun1, Lingyun, Zhang1, Huayong, Feng1, Xuebing, Wang1, Dandan, Gilkeson2, GS, Silver2, Richard M.
To assess the efficacy and safety of allogenic bone marrow or umbilical cord derived mesenchymal stem cell transplantation (MSCT) for patients with refractory systemic lupus erythematosus (SLE).
13 patients with SLE refractory to immunosuppressive therapies were enrolled from March 2007 through May 2009, 11 female and 2 male, aged 16~42(mean 28±8.8 years). All the patients fulfilled the 1997 American Collage Rheumatology (ACR) SLE criteria and 12 had lupus nephritis (LN). Disease duration was from 12 to 192 months.The study was approved by the Ethics Committee of the Affiliated Drum Tower Hospital of Nanjing University Medical School. Bone marrow derived mesenchymal stem cells (MSCs) were aspirated from related healthy donors and expanded in vitro, and umbilical cord derived MSCs were obtained from National Engineering Research Center of Cell Products, Tianjing, China (NECCP). 12 patients were given cyclophosphamide (CTX) 0.6~2.2g divided by two to four times except for one patient with severe myelosuppression and poor health condition, then MSCs were administered 1.0×106/kg body weight intravenously, for 11 patients with bone marrow derived MSCs and 2 patients with umbilical cord derived MSCs. The clinical manifestations and laboratory parameters were compared before and after MSCT with a follow-up of 12 to 25 months(mean19 months).
Remission of disease activity (Systemic Lupus Erythematosus Disease Activity Index, SLEDAI less than 3 and prednisone dose less than 10mg/d) was seen in 7/13 (54%) evaluable patients at 1 year and 3/5 (60%) at 2 year after MSCT. Two patients with drug withdrawal relapsed at 1 year post MSCs transplantation. Amelioration of LN was found for the 12 patients, including significant decline of 24-hour proteinuria at 1 year (2162.5±796.0 vs 724.3±313.5mg, P<0.01), and at 2 years (281.5±120.5mg, n=4) after transplantation. The high serum creatinine levels of three patients also returned to normal at 6 months after transplantation. A significant improvement of glomerular filtration rate (GFR) was found in two patients at 4 months after MSCT. In addition, serum albumin and complement 3 (C3) increased combined with the significant decline of autoantibodies as well as normalization hematological disorder. One relapsed patients has been given a second MSCT and remission of lupus has been also found. No transplant related mortality or any significant toxicity was observed and overall survival was 100%.
This study demonstrates that allogenic MSCT has a potential effect and safety for refractory SLE.
To cite this abstract, please use the following information:
Sun, Lingyun, Zhang, Huayong, Feng, Xuebing, Wang, Dandan, Gilkeson, GS, Silver, Richard M.; Allogenic Mesenchymal Stem Cells Transplantation for Patients with Systemic Lupus Erythematosus: One-Year Fellowup [abstract]. Arthritis Rheum 2009;60 Suppl 10 :2074