Session Type: Abstract Submissions (ACR)
Background/Purpose Allogeneic mesenchymal stem cell transplantation (MSCT) has been shown to be clinically efficacious in the treatment of various autoimmune diseases. Here we analyzed the role of allogeneic MSCT to induce renal remission in patients with active and refractory lupus nephritis (LN).
Methods This is an open-label and single-center clinical trial conducted from 2007 to 2010 in which 81 Chinese patients with active and refractory lupus nephritis were enrolled. Allogeneic bone marrow- or umbilical cord-derived mesenchymal stem cells (MSCs) were administered intravenously at the dose of one million cells per kilogram of bodyweight. All patients were then monitored over the course of 12 months with periodic follow-up visits to evaluate renal remission, as well as possible adverse events. The primary outcome was complete renal remission (CR) and partial remission (PR) at each follow-up, as well as renal flares. The secondary outcome included renal activity score, total disease activity score, renal function and serologic index.
Results During the 12-month follow-up, the overall rate of survival was 95% (77/81). Totally 60.5% (49/81) patients achieved renal remission during 12-month visit by MSCT. Eleven of 49 (22.4%) patients experienced renal flare by the end of 12 months after a previous remission. Renal activity evaluated by BILAG scores significantly declined after MSCT (mean±SD, from 4.48±2.60 at baseline to 1.09±0.83 at 12-month), in parallel with the obvious amelioration of renal function. Glomerular filtration rate (GFR) improved significantly 12 months after MSCT (mean±SD, from 58.55±19.16 mL/min to 69.51±27.93 mL/min). Total disease activity evaluated by SLEDAI scores also decreased after treatment (mean±SD, from 13.11±4.20 at baseline to 5.48±2.77 at 12 month). Additionally, the doses of concomitant prednisone and immunosuppressive drugs were tapered. No transplantation-related adverse event was observed.
Conclusion Allogeneic MSCT resulted in renal remission for active LN patients within 12 months visit, confirming its use as a potential therapy for refractory LN.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/allogeneic-mesenchymal-stem-cell-transplantation-for-lupus-nephritis-patients-refractory-to-conventional-therapy/