Mesenchymal Stem Cells in Acquired Aplastic Anemia: The Spectrum from Basic to Clinical Utility

Int J Mol Sci. 2023 Feb 24;24(5):4464. doi: 10.3390/ijms24054464.

Abstract

Aplastic anemia (AA), a rare but potentially life-threatening disease, is a paradigm of bone marrow failure syndromes characterized by pancytopenia in the peripheral blood and hypocellularity in the bone marrow. The pathophysiology of acquired idiopathic AA is quite complex. Mesenchymal stem cells (MSCs), an important component of the bone marrow, are crucial in providing the specialized microenvironment for hematopoiesis. MSC dysfunction may result in an insufficient bone marrow and may be associated with the development of AA. In this comprehensive review, we summarized the current understanding about the involvement of MSCs in the pathogenesis of acquired idiopathic AA, along with the clinical application of MSCs for patients with the disease. The pathophysiology of AA, the major properties of MSCs, and results of MSC therapy in preclinical animal models of AA are also described. Several important issues regarding the clinical use of MSCs are discussed finally. With evolving knowledge from basic studies and clinical applications, we anticipate that more patients with the disease can benefit from the therapeutic effects of MSCs in the near future.

Keywords: aplastic anemia; bone marrow failure; cell therapy; mesenchymal stem cells.

Publication types

  • Review

MeSH terms

  • Anemia, Aplastic* / pathology
  • Animals
  • Bone Marrow / pathology
  • Mesenchymal Stem Cells* / physiology
  • Pancytopenia*

Supplementary concepts

  • Aplastic anemia, idiopathic

Grants and funding

This study was supported by the Ministry of Science and Technology (MOST 110-2314-B-040-012) and the Chung Shan Medical University Hospital (CSH-2023-C-018).