ORIGINAL RESEARCH article
Front. Med.
Sec. Hematology
Haploidentical Transplantation Combined with Mesenchymal Stem Cells Co-infusion Improves Survival in Severe Aplastic Anemia: A Single-Center Retrospective Study
Provisionally accepted
Zhengwei Tan
Miaoya LeNingning ZhuJingjing LiuYuechao ZhaoHuijin HuQinghong YuYu ZhangLiqiang WuTonglin HuDijiong WuBaodong Ye
Wenbin Liu*- The First Affiliated Hospital of Zhejiang Chinese Medical University, Hangzhou, China
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Haploidentical hematopoietic stem cell transplantation (HID-HSCT) serves as an alternative treatment for severe aplastic anemia (SAA) patients lacking a suitable HLA-identical sibling donor. Compared to HLA-matched HSCT, HID-HSCT has higher rates of graft failure (GF) and graft-versus-host disease (GVHD). Recent studies suggest promising clinical outcomes when Mesenchymal stem cells (MSCs) are combined with HID-HSCT for SAA treatment. This study retrospectively analyzed clinical data from 190 SAA patients who underwent HID-HSCT with or without MSCs co-infusion. Patients were divided into two groups: the HID group (100 patients receiving only HID-HSCT) and the HID+MSC group (90 patients receiving HID-HSCT combined with MSC co-infusion). The analysis revealed that the HID+MSC group had a significantly higher 5-year overall survival rate compared to the HID group (86.6% vs 75.0%, P = 0.036) and a significantly improved GRFS rate (76.6% vs 64.0%, P = 0.048). While MSCs co-infusion did not significantly reduce the incidence of aGVHD or cGVHD, a downward trend was observed, particularly for cGVHD (16.6% vs 26.0%). Both groups showed high cumulative engraftment rates for NE and PLT within 28 days post-transplant, with no significant differences. Regarding viral reactivation, EBV and CMV reactivation rates were similar between the two groups, though 4 patients in the HID group developed EBV-associated PTLD. This study demonstrates that combining HID-HSCT with MSCs co-infusion is a safe and effective therapeutic strategy that significantly improves survival rates and quality of life in SAA patients.
Keywords: aplastic anemia, Haploidentical hematopoietic stem cell transplantation, Mesenchymal Stem Cells, graft-versus-host disease, overall survival
Received: 24 Sep 2025; Accepted: 17 Nov 2025.
Copyright: © 2025 Tan, Le, Zhu, Liu, Zhao, Hu, Yu, Zhang, Wu, Hu, Wu, Ye and Liu. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Wenbin Liu, szyyblood@163.com
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