Mesenchymal stem cells therapy for immune thrombocytopenia in pregnancy: a case report

Immune thrombocytopenia (ITP) during pregnancy poses unique therapeutic challenges due to the risk of maternal hemorrhage, fetal thrombocytopenia, and the safety limitations of standard treatments such as corticosteroids and intravenous immunoglobulin (IVIG). Mesenchymal stem cells (MSCs), particularly those derived from umbilical cord tissue (UC-MSCs), have shown immunomodulatory and hematopoietic supportive properties in refractory ITP, but their use during pregnancy has not been previously reported.

We report the case of a 41-year-old woman with a 10-year history of ITP who conceived with a baseline platelet count of 54 × 10⁹/L at 8 weeks of gestation. During pregnancy, she self-initiated UC-MSCs infusions outside guideline-directed care (five courses, 60 × 10⁶ cells/day for three consecutive days per course), followed by two postpartum courses. Platelet counts during pregnancy were maintained between 41-94 × 10⁹/L and rose to 154 × 10⁹/L postpartum. No infusion-related adverse events were observed. The pregnancy was uneventful, with no maternal hemorrhage or fetal growth restriction, and both mother and neonate had favorable outcomes.

This report documents the first maternal-fetal outcomes following non-standard UC-MSCs exposure in pregnancy complicated by ITP. While not medically indicated, this case highlights the reality of patient-driven use of experimental therapies and underscores the urgent need for systematic studies to evaluate maternal-fetal safety.