Graft versus host disease (GVHD) is a difficult and potentially lethal complication of Bone Marrow stem cell transplantation and few other organ transplantations. It occurs with minor human leucocyte antigen (HLA) mismatch and is normally treated with corticosteroid and other immunosuppressive treatments/drugs. When it is not responding to steroid therapy, then mortality reaches up to 80%. Mesenchymal stem cells (MSCs) are versatile cells found in umbilical cord and other tissues.
They can be expanded i.e cultured and have potent and diverse immunomodulatory property. Additionally, human mesenchymal stem cells carry low levels of class 1 and no class 2 HLA antigens, thereby making them immunoprivileged and hence can be used without HLA matching under certain circumstances. Their use in steroid-refractory graft versus host disease was first described in 2004. Subsequently, they have been used in a number of Phase I and II trials in acute and chronic graft versus host disease trials with success.
Canadian and New Zealand FDAs have recently given approvals for the use of bone marrow MSCs in humans