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MSC for the improvement of hematopoietic engraftment

Bone Marrow Transplantation volume 45, pages 605–606 (2010)Cite this article

A recent issue of Bone Marrow Transplantation included the results of a clinical trial from Minnesota of 15 pediatric patients who were transplanted with umbilical cord blood in combination with pre-expanded MSCs in an attempt to accelerate hematopoietic recovery.1 According to our present understanding, MSCs, osteoblasts and other stromal cells, including sinusoidal and endothelial, are responsible for supporting hematopoiesis and controlling HSC number. Therefore a co-transplantation of these cells, together with HSC, can be more effective in the reconstitution of hematopoiesis. This approach is especially attractive for cases with a predicted poor engraftment due to both an insufficient number of transplanted HSCs or impaired stroma.

As far back as the early 1970s, Friedenstein2 showed that MSCs support hematopoiesis after local transplantation and lose this ability after i.v. BMT. Nevertheless, starting from 2000, several groups, including the group from Minnesota, have reported data showing their experience with the use of MSCs in adults or children with malignant or nonmalignant diseases, after myeloablative or reduced-intensity conditioning, in transplant from autologous, matched sibling or mismatched T-cell-depleted graft, including BM, PBSCs or umbilical cord blood as a source of hematopoietic stem cells.1, 3, 4, 5, 6, 7, 8 In spite of the variability of the cases, several conclusions can be drawn from these trials. First, except for one case of urticaria,9 any immediate side effects from an i.v. transfusion of MSCs were not described. Second, the kinetics and homing of MSCs were evaluated in some studies: Koc et al.3 detected infused MSCs in circulation up to 1 h after infusion of autologous MSCs; Lazarus et al.4 found donor-derived MSCs in short-term MSC cultures from 2 out of 18 patients; Ball et al.5 found minimal (1–2%) and transient chimerism in ex vivo expanded MSCs in 3 out of 14 patients; and only Poloni et al.,6 using PCR and FISH found a reasonable mixed chimerism of stromal cells in 8 out of 22 patients, which was reversible in 4 of them (7–86% up to 30 months after transplantation). Last but not the least, none of the above mentioned studies showed a clinically significant association between infusion of MSC, number of MSCs, stromal chimerism and hematopoietic engraftment.

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  1. Department of Bone Marrow Transplantation, Hadassah Hebrew University Medical Center, Cancer Immunotheraphy and Immunobiology Research Center, Jerusalem, Israel

    I Resnick, P Stepensky, G Elkin, C Barkatz, O Gurevich, T Prigozhina, E Pikarsky, E Waldman, A Amar, S Samuel, M Shapira, M Weintraub & R Or

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Resnick, I., Stepensky, P., Elkin, G. et al. MSC for the improvement of hematopoietic engraftment. Bone Marrow Transplant 45, 605–606 (2010). https://doi.org/10.1038/bmt.2009.199

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