Acute graft-versus-host disease (aGvHD) continues to impact morbidity and mortality after allogeneic stem cell transplantation (allo-SCT). First-line therapy for aGvHD still remains the use of high-dose corticosteroids. Unfortunately, 40–60% of patients with aGvHD exhibit steroid resistance, which is associated with a very poor prognosis. As no effective second-line therapy existed, in recent decades various treatment options were considered for the treatment of therapy-refractory GvHD. Based on their in vitro immunomodulatory properties, the use of mesenchymal stromal cells (MSCs) in the treatment of aGvHD has been introduced. However, most of the clinical data are generated from uncontrolled trials and case series, showing clinical responses to MSCs. Clinical results are more consistent in children despite the use of MSC preparations of various provenance and manufacturing protocols. While these data support the therapeutic principle, the great variability of outcomes strongly suggests that not all MSC preparations are equal and that the specific manufacturing protocols influence therapeutic success in vivo.

中文翻译：

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间充质基质细胞在治疗急性移植物抗宿主病中的临床应用

急性移植物抗宿主病 (aGvHD) 继续影响同种异体干细胞移植 (allo-SCT) 后的发病率和死亡率。aGvHD 的一线治疗仍然是使用高剂量皮质类固醇。不幸的是，40-60% 的 aGvHD 患者表现出类固醇抵抗，这与非常差的预后有关。由于不存在有效的二线疗法，近几十年来，人们考虑了各种治疗方案来治疗难治性 GvHD。基于它们的体外免疫调节特性，已经引入了间充质基质细胞 (MSC) 在 aGvHD 治疗中的应用。然而，大多数临床数据来自非对照试验和病例系列，显示了对 MSC 的临床反应。尽管使用了各种来源和制造协议的 MSC 制剂，但儿童的临床结果更加一致。虽然这些数据支持治疗原则，但结果的巨大可变性强烈表明并非所有的 MSC 制剂都是相同的，并且特定的制造协议会影响体内治疗的成功。