Mesenchymal stem cell infusion to accelerate hematopoietic recovery after transplantation: A comprehensive systematic review of clinical studies (2000-2025).

Background: Hematopoietic stem cell transplantation (HSCT) is a standard therapy for various hematologic diseases, yet delayed engraftment remains a significant challenge. Mesenchymal stem cells (MSCs) have attracted attention for their potential to enhance hematopoietic recovery due to their immunomodulatory and supportive functions. This systematic review aimed to evaluate the clinical impact of MSC infusion on engraftment outcomes after HSCT.

Method: We systematically searched PubMed, Embase, Scopus, Web of Science, and Cochrane Library for clinical studies published between 2000 and 2025. Eligible studies included randomized trials, cohort studies, and case series that assessed MSCs for improving engraftment. Data were synthesized qualitatively.

Result: Forty-seven studies involving 1777 patients were included. MSCs were primarily derived from bone marrow or umbilical cord and administered intravenously. Approximately 79 % of the studies reported enhanced engraftment, with particular benefit for platelet recovery. The average neutrophil and platelet engraftment times in MSC recipients were 13.96 and 21.61 days, respectively. No serious adverse events related to MSC infusion were reported.

Conclusion: Current clinical evidence supports the safety and potential efficacy of MSCs in promoting hematopoietic engraftment, especially platelet recovery, in HSCT recipients. Further high-quality randomized trials are required to confirm these findings. This systematic review is registered in PROSPERO (CRD420251082387).