Mezenhimske matične/stromalne stanice (MSC) imaju središnju ulogu u mikrookolišu koštane srži te pokazuju snažna imunomodulatorna i regenerativna svojstva, zbog čega predstavljaju privlačnu terapijsku opciju u hematologiji i kod krvnih zloćudnih bolesti. Istodobno, u određenim okolnostima MSC mogu podržavati preživljenje i rast malignih stanica, stoga njihova primjena u hemato-onkologiji mora biti pažljivo nadzirana i stručno vođena.
MSC podupiru hematopoetske matične stanice te se koriste za poboljšanje uspješnosti prihvaćanja presatka (engraftmenta) i kliničkih ishoda nakon transplantacije hematopoetskih matičnih stanica (HSCT) kod leukemija i drugih hematoloških bolesti (Lan i sur., 2021; Smallbone i sur., 2025). Njihovi imunosupresivni učinci koriste se za liječenje ili prevenciju reakcije presatka protiv domaćina (GVHD) te za obnovu oštećene koštane srži nakon kemoterapije ili radioterapije (Wu i sur., 2024; Lan i sur., 2021; Najar i sur., 2022; Smallbone i sur., 2025).
MSC i njihovi egzosomi mogu utjecati na leukemijsko mikrookruženje, uzrokovati zaustavljanje staničnog ciklusa, potaknuti apoptozu te smanjiti kemorezistenciju kod nekih oblika leukemije, što upućuje na njihov izravni antileukemijski potencijal i mogućnost sinergije sa standardnim terapijama (Saadh i sur., 2025; Wu i sur., 2024; Fathi i sur., 2019; Ahmad i sur., 2025). Genetski modificirane MSC razvijaju se kao tzv. „trojanski konji“ za ciljanu dostavu citokina, suicidnih gena, protutijela ili koagulacijskih faktora kod leukemija, limfoma, mijeloma te nasljednih krvnih bolesti poput anemije i hemofilije (Hmadcha i sur., 2020; Shomali i sur., 2020; Chulpanova i sur., 2018; Kangari i sur., 2024).
| Strategija | Terapijski cilj u hematologiji/hemato-onkologiji | Reference |
|---|---|---|
| Istodobna primjena MSC s HSCT | Poboljšanje prihvaćanja presatka, smanjenje GVHD-a, obnova niše koštane srži | (Wu et al., 2024; Lan et al., 2021; Crippa et al., 2019; Najar et al., 2022; Smallbone et al., 2025) |
| Egzosomi dobiveni iz MSC | Bezstanična regulacija upale, kemorezistencije i tumorskog rasta | (Saadh et al., 2025; Ahmad et al., 2025; Lin et al., 2022) |
| MSC kao nosači gena/lijekova | Ciljana dostava antitumorskih gena, citokina i terapijskih čimbenika kod krvnih bolesti | (Hmadcha et al., 2020; Shomali et al., 2020; Chulpanova et al., 2018) |
Slika 1: Glavne kliničke i eksperimentalne primjene mezenhimskih matičnih stanica u hematologiji.
Mezenhimske matične stanice (MSC) predstavljaju važno terapijsko sredstvo u hemato-onkologiji: podupiru transplantaciju hematopoetskih matičnih stanica (HSCT), reguliraju imunološki odgovor, omogućuju dostavu terapijskih molekula te putem egzosoma nude obećavajuće bezstanične terapijske strategije.
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