Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study

Abstract Background The intricate and varied clinical presentations of systemic sclerosis (SSc) pose significant challenges for treatment. While several studies have investigated the therapeutic potential of mesenchymal stem cell transplantation (MSCT), the clarity of its long-term outcomes for SSc...

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Main Authors: Wenyi Yuan, Mian Liu, Dapeng Yang, Yirui Shi, Zhikang Wang, Xuan Cao, Jun Liang, Linyu Geng, Huayong Zhang, Xuebing Feng, Ziyi Jin, Dandan Wang, Lingyun Sun
Format: Article
Language:English
Published: BMC 2025-03-01
Series:Stem Cell Research & Therapy
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Online Access:https://doi.org/10.1186/s13287-025-04237-1
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author Wenyi Yuan
Mian Liu
Dapeng Yang
Yirui Shi
Zhikang Wang
Xuan Cao
Jun Liang
Linyu Geng
Huayong Zhang
Xuebing Feng
Ziyi Jin
Dandan Wang
Lingyun Sun
author_facet Wenyi Yuan
Mian Liu
Dapeng Yang
Yirui Shi
Zhikang Wang
Xuan Cao
Jun Liang
Linyu Geng
Huayong Zhang
Xuebing Feng
Ziyi Jin
Dandan Wang
Lingyun Sun
author_sort Wenyi Yuan
collection DOAJ
description Abstract Background The intricate and varied clinical presentations of systemic sclerosis (SSc) pose significant challenges for treatment. While several studies have investigated the therapeutic potential of mesenchymal stem cell transplantation (MSCT), the clarity of its long-term outcomes for SSc patients is still lacking. Methods Data on MSCT were extracted from the medical records of inpatients at Nanjing Drum Tower Hospital between January 2013 and December 2022. Additionally, Baseline characteristics and survival outcomes were ascertained from medical records and telephone follow-up. Propensity score matching (PSM) was employed to equalize the baseline characteristics of the patient groups, while survival analysis and multivariate Cox regression assessed the relationship between received MSCT and all-cause mortality and disease-specific survival rates in SSc patients. Results Of the 333 hospitalized SSc patients, 113 patients underwent MSCT. The log-rank test revealed significantly higher survival rates in the MSCT group compared to the control group (10-year survival rate 89.4% vs. 73.4%, P = 0.002). In the PSM cohort, receiving MSCT significantly reduced mortality (10-year survival 88.0% vs. 79.9%, P = 0.032). Multivariate Cox regression analysis indicated that MSCT was linked to a reduced mortality risk during the follow-up period (HR 0.38, 95% CI 0.19–0.75, P = 0.005). This finding was further confirmed in the matched cohort (HR 0.38, 95% CI 0.18–0.82, P = 0.014). Subgroup analyses revealed that treated with MSCT was correlated with reduced mortality in patients of various demographics, including younger age at diagnosis (≤ 47 years), female, diffuse cutaneous systemic sclerosis (dcSSc) subtype, concurrent arthritis, pulmonary arterial hypertension (PAH), and interstitial lung disease (ILD). Conclusion MSCT significantly enhances the survival rate of patients with SSc, with outcomes related to the age at diagnosis. MSCT is particularly indicated for patients with comorbid conditions, including PAH, ILD, digital ulcers, and arthritis, as well as those with severe disease presentations associated with the dcSSc subtype.
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spelling doaj-art-040102f610ce49d1b29df50a3b0ea9b32025-08-20T02:56:16ZengBMCStem Cell Research & Therapy1757-65122025-03-0116111210.1186/s13287-025-04237-1Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort studyWenyi Yuan0Mian Liu1Dapeng Yang2Yirui Shi3Zhikang Wang4Xuan Cao5Jun Liang6Linyu Geng7Huayong Zhang8Xuebing Feng9Ziyi Jin10Dandan Wang11Lingyun Sun12Department of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Xuzhou Medical UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing UniversityDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineDepartment of Rheumatology and Immunology, Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese MedicineAbstract Background The intricate and varied clinical presentations of systemic sclerosis (SSc) pose significant challenges for treatment. While several studies have investigated the therapeutic potential of mesenchymal stem cell transplantation (MSCT), the clarity of its long-term outcomes for SSc patients is still lacking. Methods Data on MSCT were extracted from the medical records of inpatients at Nanjing Drum Tower Hospital between January 2013 and December 2022. Additionally, Baseline characteristics and survival outcomes were ascertained from medical records and telephone follow-up. Propensity score matching (PSM) was employed to equalize the baseline characteristics of the patient groups, while survival analysis and multivariate Cox regression assessed the relationship between received MSCT and all-cause mortality and disease-specific survival rates in SSc patients. Results Of the 333 hospitalized SSc patients, 113 patients underwent MSCT. The log-rank test revealed significantly higher survival rates in the MSCT group compared to the control group (10-year survival rate 89.4% vs. 73.4%, P = 0.002). In the PSM cohort, receiving MSCT significantly reduced mortality (10-year survival 88.0% vs. 79.9%, P = 0.032). Multivariate Cox regression analysis indicated that MSCT was linked to a reduced mortality risk during the follow-up period (HR 0.38, 95% CI 0.19–0.75, P = 0.005). This finding was further confirmed in the matched cohort (HR 0.38, 95% CI 0.18–0.82, P = 0.014). Subgroup analyses revealed that treated with MSCT was correlated with reduced mortality in patients of various demographics, including younger age at diagnosis (≤ 47 years), female, diffuse cutaneous systemic sclerosis (dcSSc) subtype, concurrent arthritis, pulmonary arterial hypertension (PAH), and interstitial lung disease (ILD). Conclusion MSCT significantly enhances the survival rate of patients with SSc, with outcomes related to the age at diagnosis. MSCT is particularly indicated for patients with comorbid conditions, including PAH, ILD, digital ulcers, and arthritis, as well as those with severe disease presentations associated with the dcSSc subtype.https://doi.org/10.1186/s13287-025-04237-1Systemic sclerosisMesenchymal stem cellsTreatmentMortality
spellingShingle Wenyi Yuan
Mian Liu
Dapeng Yang
Yirui Shi
Zhikang Wang
Xuan Cao
Jun Liang
Linyu Geng
Huayong Zhang
Xuebing Feng
Ziyi Jin
Dandan Wang
Lingyun Sun
Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study
Stem Cell Research & Therapy
Systemic sclerosis
Mesenchymal stem cells
Treatment
Mortality
title Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study
title_full Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study
title_fullStr Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study
title_full_unstemmed Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study
title_short Improvement in long-term survival with mesenchymal stem cell transplantation in systemic sclerosis patients: a propensity score-matched cohort study
title_sort improvement in long term survival with mesenchymal stem cell transplantation in systemic sclerosis patients a propensity score matched cohort study
topic Systemic sclerosis
Mesenchymal stem cells
Treatment
Mortality
url https://doi.org/10.1186/s13287-025-04237-1
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