BACKGROUND:Currently,the main treatment for aplastic anemia is hematopoietic stem cell transplantation and immunosuppressive therapy.However,treatment-induced complications and adverse effects seriously affect the prognosis and quality of life of patients with aplastic anemia.Mesenchymal stem cells have a unique low immunogenicity,which can inhibit the proliferation and activation of T-lymphocytes,B-lymphocytes,dendritic cells,and natural killer cells,and regulate the body's immunity.Mesenchymal stem cells hold promise for cell therapy for aplastic anemia and graft-versus-host disease.OBJECTIVE:To review the progress of the application of mesenchymal stem cells in aplastic anemia in recent years,and the correlation between mesenchymal stem cells and the pathogenesis of aplastic anemia.This article hopes to provide patients with aplastic anemia with a new theoretical basis for treatment and more effective treatment options.METHODS:PubMed database and CNKI database were searched from January 2003 to February 2024.The search terms included"aplastic anemia,mesenchymal stem cells,hematopoietic stem cells,hematopoiesis,hematopoietic microenvironment,hematopoietic stem cell transplantation,biology,immunity,graft-versus-host disease"in Chinese and"aplastic anemia,mesenchymal stem cell,hematopoietic stem cell,hematopoiesis,hematopoietic microenvironment,hematopoietic stem cell transplantation,biology,immuno-modulatory,immune regulation,graft-versus-host disease,chronic graft-versus-host disease,acute graft-versus-host disease"in English.Low-quality,repetitive,and outdated articles were excluded,and 88 papers were finally included for review and analysis.RESULTS AND CONCLUSION:(1)As a kind of pluripotent stem cells,mesenchymal stem cells can remodel hematopoietic function through direct cell-to-cell contact,secretion of various hematopoietic-related factors,and participation in hematopoietic-related pathways.(2)Compared with mesenchymal stem cells combined with immunosuppressant infusion and infusion of mesenchymal cells alone,mesenchymal stem cells combined with hematopoietic stem cell transplantation for the treatment of patients with aplastic anemia can better utilize the therapeutic efficacy of the two types of stem cells,significantly reduce the incidence of chronic and Ⅲ-Ⅳ acute graft-versus-host disease,and improve the overall survival of patients.(3)Protocols that use mesenchymal stem cells of umbilical cord origin and＜6 passages and that are infused prior to hematopoietic stem cell transplantation may be more effective therapeutic options.(4)There is a close link between mesenchymal stem cells and the pathogenesis of aplastic anemia,which may lead to new therapeutic options for aplastic anemia through the inhibition or activation of relevant targets in the pathological evolution of aplastic anemia.

BACKGROUND:Currently,the main treatment for aplastic anemia is hematopoietic stem cell transplantation and immunosuppressive therapy.However,treatment-induced complications and adverse effects seriously affect the prognosis and quality of life of patients with aplastic anemia.Mesenchymal stem cells have a unique low immunogenicity,which can inhibit the proliferation and activation of T-lymphocytes,B-lymphocytes,dendritic cells,and natural killer cells,and regulate the body's immunity.Mesenchymal stem cells hold promise for cell therapy for aplastic anemia and graft-versus-host disease.OBJECTIVE:To review the progress of the application of mesenchymal stem cells in aplastic anemia in recent years,and the correlation between mesenchymal stem cells and the pathogenesis of aplastic anemia.This article hopes to provide patients with aplastic anemia with a new theoretical basis for treatment and more effective treatment options.METHODS:PubMed database and CNKI database were searched from January 2003 to February 2024.The search terms included"aplastic anemia,mesenchymal stem cells,hematopoietic stem cells,hematopoiesis,hematopoietic microenvironment,hematopoietic stem cell transplantation,biology,immunity,graft-versus-host disease"in Chinese and"aplastic anemia,mesenchymal stem cell,hematopoietic stem cell,hematopoiesis,hematopoietic microenvironment,hematopoietic stem cell transplantation,biology,immuno-modulatory,immune regulation,graft-versus-host disease,chronic graft-versus-host disease,acute graft-versus-host disease"in English.Low-quality,repetitive,and outdated articles were excluded,and 88 papers were finally included for review and analysis.RESULTS AND CONCLUSION:(1)As a kind of pluripotent stem cells,mesenchymal stem cells can remodel hematopoietic function through direct cell-to-cell contact,secretion of various hematopoietic-related factors,and participation in hematopoietic-related pathways.(2)Compared with mesenchymal stem cells combined with immunosuppressant infusion and infusion of mesenchymal cells alone,mesenchymal stem cells combined with hematopoietic stem cell transplantation for the treatment of patients with aplastic anemia can better utilize the therapeutic efficacy of the two types of stem cells,significantly reduce the incidence of chronic and Ⅲ-Ⅳ acute graft-versus-host disease,and improve the overall survival of patients.(3)Protocols that use mesenchymal stem cells of umbilical cord origin and＜6 passages and that are infused prior to hematopoietic stem cell transplantation may be more effective therapeutic options.(4)There is a close link between mesenchymal stem cells and the pathogenesis of aplastic anemia,which may lead to new therapeutic options for aplastic anemia through the inhibition or activation of relevant targets in the pathological evolution of aplastic anemia.