Background/Purpose: Allogenic mesenchymal stem cells (MSCs) transplantation demonstrated significant clinical efficacy on various autoimmune diseases. Here we retrospectively analyzed the role of allogenic MSCs transplantation in renal remission in patients with active and refractory lupus nephritis (LN).

Methods: Eighty-one patients with active and refractory lupus nephritis in China from 2007 to 2010 were enrolled in the study. Allogenic bone marrow or umbilical cord derived MSCs were administered intravenously at the dose of one million cells per kilogram of bodyweight. Then all the patients were followed up for 12 months to evaluate renal remission as well as possible adverse events. The primary outcomes were renal complete remission (CR) and partial remission (PR) at each visit times, as well as renal flares. The secondary outcomes included renal activity score, total disease activity score, renal function and serologic index. Rates of overall survival, renal remission, as well as relapse at different visit times were calculated by using the Kaplan-Meier method and were statistically tested with the log-rank test. We calculated the HR and their 95% CIs using the univariate Coxproportional hazards model.

Results: The overall survival rate during 12 months follow-up was 95% (77/81). The probability of renal remission was 41% (18% CR and 23% PR) at 3 months, 45% (18% CR and 27% PR) at 6 months and 44% (23% CR and 21% PR) at 12 months after allogenic MSCs transplantation. Renal remission was not correlated with age, disease duration, MSCs source and baseline SLEDAI score, but was significantly correlated with baseline proteinuria (P=0.003, 95%CI 0.336-0.794) and serum creatinine levels (P=0.047, 95%CI 0.224-0.990) by COX regression analysis. Eleven in 81 (14%) patients underwent renal flare in 12 months follow up after a prior complete or partial remission. Renal activity evaluated by BILAG score significantly declined after MSCT, in parallel with the obvious amelioration of renal function. Total disease activity evaluation by SLEDAI score also decreased after treatment. Additionally, the doses of concomitant prednisone and immunosuppressive drugs were tapered. Four of 81 patients died of uncontrolled lupus nephritis unrelated to MSCT.

Conclusion: Allogenic MSCs transplantation resulted in renal remission within 12 months visit, which could be used early as a potential induction therapy for active and refractory lupus nephritis.

---

« Back to 2012 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/retrospective-study-of-allogenic-mesenchymal-stem-cells-transplantation-in-active-and-refractory-lupus-nephritis-for-induction-therapy/