Hematological Diseases Clinical Trial
Official title:
Mesenchymal Stem Cells With or Without G-CSF Mobilized Peripheral Blood Stem Cell for Treatment of Poor Graft Function and Delayed Platelet Engraftment After Allogeneic Hematopoietic Stem Cell Transplant
The purpose of this study is to compare the efficacy of mesenchymal stem cells (MSCs) with or without granulocyte colony-stimulating factor (G-CSF) mobilized peripheral stem cells (PBSC) in treating patients experiencing poor graft function or delayed platelet engraftment after allogeneic hematopoietic stem cell transplantation.
Allogeneic hematopoietic stem cell transplantation(allo-HSCT) is the only cure for many
hematologic diseases. However, about 5-27% of patients would suffer from poor graft function
(PGF) and more recipients might develop delayed platelet engraftment (DPE) after allo-HSCT.
These complications are associated with considerable mortality related to infections or
hemorrhagic complications. Treatment of PGF and DPE usually involves hematopoietic growth
factors such as granulocyte colony-stimulating factor (G-CSF) and thrombopoietin (TPO), or
second transplantation, but these methods have dismal effect or even a significant risk of
graft-versus-host disease (GVHD).
Mesenchymal stem cells (MSCs) are a form of multipotent adult stem cells that can be
isolated from bone marrow (BM), adipose tissue, and cord blood. Clinical applications of
human MSCs include improving hematopoietic engraftment, preventing and treating
graft-versus-host disease after allo-HSCT and so on. Some studies have shown that MSCs
combined with PBSC or cord blood could be useful to improve engraftment after HSCT. Several
reports suggested MSCs might be effective in the treatment of PGF.
However, the efficacy of MSCs as single-drug treatment for PGF or DPE is unsatisfactory in
our previous study. Therefore, in the present study, G-CSF mobilized PBSC will be used
combined with MSCs in the patients with PGF or DPE after allo-HSCT.
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Allocation: Randomized, Endpoint Classification: Efficacy Study, Intervention Model: Parallel Assignment, Masking: Open Label, Primary Purpose: Treatment
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