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Background: Refractory acute graft versus host disease (aGVHD) is one of the major causes of death after allogenetic haematopoietic stem cell transplantation (allo-HSCT).Aims: This study evaluated the efficacy and safety of mesenchymal stem cells (MSCs) from the bone marrow of a third-party donor to refractory aGVHD.Methods: Twenty-seven patients with refractory aGVHD were enrolled in this prospective study.