Li Zhen, Zhuang Sujing, Gui Ruirui, Zhang Binglei, Zhang Wenli, Wang Juan, Zu Yingling, Yang Fei, Xin Xiangke, Liu Yanyan, Zhang Yanli, Fang Baijun, Yu Fengkuan, Zhao Huifang, Li Wei, Song Yongping, Zhou Jian
Department of Haematology, Affiliated Cancer Hospital of Zhengzhou University and Henan Cancer Hospital, Zhengzhou, Henan, China.
Shandong Qilu Stem Cell Engineering Co. LTD., High-tech Development Zone, Jinan, Shandong, China.
Front Oncol. 2025 Jun 3;15:1585088. doi: 10.3389/fonc.2025.1585088. eCollection 2025.
Pure red cell aplasia (PRCA) is one of the complications after allogeneic hematopoietic stem cell transplantation (allo-HSCT). Its main pathogenesis is immune dysfunction leading to erythrocytes destruction. Currently, there is no gold standard for PRCA after allo-HSCT. Umbilical cord blood (UCB) and mesenchymal stem cells (MSCs) have been widely used in hematological and immune system diseases due to their hematopoietic reconstitution and immunomodulatory functions. However, few studies about using UCB and MSCs to treat PRCA after allo-HSCT have been reported.
In this report, different cell therapy regimens of UCB and MSCs were used in 3 acute myeloid leukemia (AML) patients diagnosed with PRCA after allo-HSCT. Results showed that all patients achieved significant progress without adverse reactions or complications. Furthermore, Case 1 treated with UCB combined with umbilical cord MSCs (UC-MSCs), and Case 2 treated with 3 doses of UCB mononuclear cells (UCB-MNC) achieved earlier RBC transfusion independence (2 months and 2 weeks after cell therapy, respectively) than Case 3 treated with one unit of UCB (3 months after cell therapy).
This report provides cell therapy strategies using UCB/UCB-MNC and UC-MSCs to treat PRCA after allo-HSCT. Our study demonstrates the safety and efficacy of 3 doses of UCB-MNC regimen and UCB combined with UC-MSCs regimen, providing a new treatment option for patients with PRCA after allo-HSCT.
纯红细胞再生障碍性贫血（PRCA）是异基因造血干细胞移植（allo-HSCT）后的并发症之一。其主要发病机制是免疫功能紊乱导致红细胞破坏。目前，allo-HSCT后PRCA尚无金标准治疗方案。脐带血（UCB）和间充质干细胞（MSCs）因其造血重建和免疫调节功能已广泛应用于血液系统和免疫系统疾病。然而，关于使用UCB和MSCs治疗allo-HSCT后PRCA的研究报道较少。
本报告中，3例allo-HSCT后诊断为PRCA的急性髓系白血病（AML）患者采用了不同的UCB和MSCs细胞治疗方案。结果显示，所有患者均取得显著进展，且无不良反应或并发症。此外，病例1采用UCB联合脐带间充质干细胞（UC-MSCs）治疗，病例2采用3剂量的UCB单个核细胞（UCB-MNC）治疗，均比病例3采用1单位UCB治疗（细胞治疗后3个月）更早实现红细胞输注独立（分别在细胞治疗后2个月和2周）。
本报告提供了使用UCB/UCB-MNC和UC-MSCs治疗allo-HSCT后PRCA的细胞治疗策略。我们的研究证明了3剂量UCB-MNC方案和UCB联合UC-MSCs方案的安全性和有效性，为allo-HSCT后PRCA患者提供了一种新的治疗选择。
