Clinical effect of cotransplantation of haploidentical hematopoietic stem cells and umbilical cord mesenchymal stem cells for patients with severe aplastic anemia

Objective To analyse the clinical effect of cotransplantation of haploidentical hematopoietic stem cells and umbilical cord mesenchymal stem cells (UC-MSCs) for patients with severe aplastic anemia (SAA). Methods Clinical data about 27 patients with haploidentical stem cells transplantation (haplo-HSCT) in our center from January 2007 to December 2013 were summarized. The engraftment, graft-versus-host disease (GVHD), overall survival (OS), disease/progression-free survival (PFS) and relapse after 2 years were observed. Results All patients given MSCs showed sustained hematopoietic engraftment without any adverse UC-MSC infusion-related reaction. The median times of transplantation of neutrophil＞ 0.50×10⁹/L and platelet＞ 20×10⁹/L engraftment were 12.0 days (8-21 days) and 14.0 days (10-26 days), respectively. Grade Ⅱ to Ⅳ and Ⅲ/Ⅳ aGVHD was observed in 11 of 27 patients (40.7%) and 6 of 27 cases (22.2%), respectively. Chronic GVHD was observed in 13 of 26 patients (50.0%) and was extensive in 4 patients (15.4%). The probability that patients would attain 2-years overall survival (OS) was 76.3%. Conclusion Cotransplantation of haploidentical hematopoietic stem cells and UC-MSCs has good treatment effect to patients with SAA without HLA-identical sibling donors or unrelated donors, which is a feasible salvage approach.