Application of umbilical cord mesenchymal stem cells in the treatment of severe immune-mediated thrombocytopenia after allogeneic hematopoietic stem cell transplantation in children.
10.7499/j.issn.1008-8830.2503173
- Author:
Bo ZHANG
1
;
Zuo LUAN
;
Xiang-Feng TANG
;
Nan-Hai WU
Author Information
1. Department of Pediatrics, Fifth People's Hospital Affiliated to Chengdu University of Chinese Medicine, Chengdu 611130, China.
- Publication Type:English Abstract
- Keywords:
Child;
Hematopoietic stem cell transplantation;
Immune-mediated cytopenia;
Immune-mediated thrombocytopenia;
Mesenchymal stem cell
- MeSH:
Child;
Humans;
Hematopoietic Stem Cell Transplantation/adverse effects*;
Mesenchymal Stem Cell Transplantation;
Purpura, Thrombocytopenic, Idiopathic/etiology*;
Thrombocytopenia/therapy*;
Transplantation, Homologous;
Umbilical Cord/cytology*
- From:
Chinese Journal of Contemporary Pediatrics
2025;27(9):1128-1133
- CountryChina
- Language:Chinese
-
Abstract:
This report describes two cases of severe immune-mediated thrombocytopenia after allogeneic hematopoietic stem cell transplantation (HSCT) who were treated with umbilical cord mesenchymal stem cells (UC-MSCs). Case 1 was a child with severe aplastic anemia who underwent haploidentical bone marrow and peripheral blood HSCT, with a chimerism rate of 99.8% on day +25 and severe immune-mediated thrombocytopenia on day +60. After intravenous immunoglobulin (IVIG) pulse therapy, platelet count increased temporarily but then decreased, while cyclosporine, methylprednisolone, and rituximab had a poor therapeutic effect. Case 2 was a child with Gaucher's disease who underwent unrelated umbilical cord blood HSCT, with a chimerism rate of 96.35% on day +41 and severe immune-mediated thrombocytopenia on day +153. After three sessions of IVIG pulse therapy, the platelet count increased initially but subsequently decreased. Therapies with dexamethasone, prednisone, cyclosporine, and recombinant human thrombopoietin also yielded a poor response. Both children received three sessions of UC-MSCs infusion, and platelet counts increased and were subsequently maintained within the normal range. Case 1 has been followed up for 10 years and remains in disease-free survival. UC-MSCs infusion may be effective for severe immune-mediated thrombocytopenia that is unresponsive to first- and second-line therapies after HSCT and could potentially improve the quality of life and disease-free survival rate.
