Mesenchymal Stem-Cell-Based Therapy for the Older Patient

Bone-marrow aspirate-derived mesenchymal stem cells (MSCs) form a core element of the vast majority of adherent, autologous stem-cell-based therapeutic clinical trials. This article explores the existing literature to determine if proposed MSC-based autologous cell therapy is suitable for use in an elderly patient population. Within the review a number of questions are asked: does the bone-marrow aspirate mononuclear cell (MNC) number, the frequency of MSC colony forming units or their proliferative potential correlate with age? Does disease state have an additional impact? Are immunophenotypes, molecular profiles or differentiation capacity linked to donor age? The answers to the above questions are essential for determining the appropriateness of elderly patients as donors and recipients for autologous MSC-based trials. Taken together, MSC yield, MNC number and proliferative potential all decrease with age while differentiation potential appears unchanged. The retention of differentiation capacity suggests that the elderly patient may be suitable for MSC-based therapy; however, only when isolation protocols are tailored in an individual-specific manner to correct for decreases in MNC number and MSC yield.