SHED-derived mesenchymal stromal cell co-infusion is associated with earlier erythroid recovery after autologous hematopoietic cell transplantation: a prospective pilot controlled study
Year: 2026
Type: article
Abstract: Delayed erythroid recovery after autologous hematopoietic stem cell transplantation (AHSCT) contributes to prolonged transfusion requirements and delayed hematopoietic reconstitution. Mesenchymal stromal cells derived from human exfoliated deciduous teeth (SHED-MSCs) exhibit hematopoietic supportive and immunomodulatory properties, but their clinical effects on erythroid recovery after AHSCT remain unknown. We evaluated whether SHED-MSC co-infusion enhances erythroid reconstitution in patients with lymphoma undergoing AHSCT. Fourteen consecutive patients undergoing AHSCT for lymphoma were enrolled in this pilot controlled study, including seven patients receiving SHED-MSC co-infusion and seven controls. Erythroid recovery was assessed longitudinally using absolute reticulocyte count, high-fluorescence reticulocytes (HFR), peak reticulocyte count, and time to predefined reticulocyte recovery. Longitudinal changes were analyzed using linear mixed-effects models adjusted for infused total nucleated cell (TNC) dose. All patients receiving SHED-MSC co-infusion achieved the predefined reticulocyte recovery threshold, whereas only one control patient reached this endpoint ( P = 0.0047). SHED-MSC recipients demonstrated earlier HFR emergence (10.6 ± 0.8 vs. 14.9 ± 5.8 days) and significantly higher peak absolute reticulocyte counts (117.6 ± 29.6 vs. 34.6 ± 22.0 × 10⁹/L; P = 0.0023). Longitudinal mixed-effects analysis demonstrated significantly accelerated erythroid recovery in the SHED-MSC group, and this association remained significant after adjustment for infused TNC dose. SHED-MSC co-infusion was associated with accelerated erythroid reconstitution following AHSCT in patients with lymphoma. These findings provide the first clinical evidence supporting a potential role for SHED-MSCs in enhancing post-transplant erythropoietic recovery and justify validation in larger prospective controlled studies. Iranian Registry of Clinical Trial (IRCT), IRCT20140911019125N10, registered on 29 May 2024.
Source: Stem Cell Research & Therapy
Language: English
Subfield: Hematology
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,190
OpenAlex ID: W7222789583
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