Allogeneic hematopoietic
cell transplantation (allo-HCT), a treatment option in
hematologic malignancies and
bone marrow failure syndromes, is frequently complicated by
Graft-versus-host disease (GVHD). The primary treatment for GVHD involves immune suppression by
glucocorticoids. However, patients are often refractory to the
steroid therapy, and this results in a poor prognosis. Therefore
alternative therapies are needed to treat GVHD. Here, we review data supporting the clinical investigation of a novel cellular
therapy using Wharton's jelly (WJ)-derived mesenchymal stromal cells (MSCs) as a potentially safe and effective therapeutic strategy in the management of GVHD. Adult-derived sources of MSCs have demonstrated signals of efficacy in the management of GVHD. However, there are limitations, including: limited proliferation capacity; heterogeneity of cell sources; lengthy expansion time to clinical dose; expansion failure in vitro; and a painful, invasive, isolation procedure for the donor. Therefore, alternative MSC sources for cellular
therapy are sought. The reviewed data suggests MSCs derived from WJ may be a safe and effective cellular
therapy for GVHD. Laboratories investigated and defined the immune properties of WJ-MSCs for potential use in cellular
therapy. These cells represent a more uniform cell population than bone marrow-derived MSCs, displaying robust immunosuppressive properties and lacking significant immunogenicity. They can be collected safely and painlessly from individuals at birth, rapidly expanded and stored cryogenically for later clinical use. Additionally, data we reviewed suggested licensing MSCs (activating MSCs by exposure to
cytokines) to enhance effectiveness in treating GVHD. Therefore, WJCs should be tested as a second generation, relatively homogeneous allogeneic cell
therapy for the treatment of GVHD.