MSCs for Enhancement of Hematopoietic Progenitor Cell Engraftment and Poor Graft Function

  • Paolo F. Caimi
  • Hillard M. Lazarus
Part of the Stem Cell Biology and Regenerative Medicine book series (STEMCELL)


Engraftment failure is a rare but life-threatening complication of hematopoietic cell transplantation (HCT). Newer approaches to HCT, including use of haploidentical donors, umbilical cord blood (UCB) transplant, nonmyeloablative and reduced-intensity conditioning regimens, appear to have an increased risk of graft failure. Multipotent mesenchymal stromal cells (MSCs) are essential bone marrow components that have the potential to differentiate in vitro into tissues along mesenchymal lineages, including bone marrow stroma. This regenerative potential, coupled with the capability to secrete cytokines and growth factors, suggests that MSCs would facilitate and promote hematopoiesis. Moreover, MSCs have immunoregulatory properties and thus could have an additional application in the setting of HCT by reducing both graft rejection and graft-versus-host disease. Initial trials have demonstrated the safety and feasibility of infusion of ex vivo-expanded autologous and allogeneic MSCs. Results from these early trials suggested MSCs may enhance hematopoiesis when infused at the time of HCT; however, subsequent trials have not yet provided confirmation that MSCs accelerate hematopoietic recovery when given shortly after HCT. Ongoing research initiatives include use of MSC infusions for patients who have some evidence of regenerating marrow but have delayed or incomplete hematopoiesis.


Umbilical Cord Blood Acute GVHD Hematopoietic Cell Transplantation Multipotent Mesenchymal Stromal Cell Bone Marrow Stroma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Department of MedicineUniversity Hospitals Case Medical Center, Case Comprehensive Cancer Center, Case Western Reserve UniversityClevelandUSA

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