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Remestemcel-L is an allogeneic, culture-expanded, bone marrow-derived mesenchymal stem cell (MSC) therapy developed by Mesoblast. When used in combination with corticosteroids, it is primarily indicated for the treatment of pediatric patients with steroid-refractory acute graft-versus-host disease (aGVHD). The MSCs exert immunomodulatory effects by responding to pro-inflammatory cytokines (such as IFN-gamma and TNF-alpha) and subsequently secreting anti-inflammatory mediators and interacting with various immune cells (T-cells, B-cells, NK cells) to dampen the cytokine storm associated with GVHD. Corticosteroids provide broad anti-inflammatory and immunosuppressive action by binding to glucocorticoid receptors. This combination therapy aims to improve clinical response rates in patients who do not achieve adequate control with standard steroid therapy alone.
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