Effectiveness of repeated transplantations of hematopoietic stem cells in spinal cord injury  

作　　者：Andrey S Bryukhovetskiy Igor S Bryukhovetskiy 

机构地区：[1]Federal Research Center for Specia-lized Types of Medical Assistance and Medical Technologies of FMBA of Russia [2]Neuro Vita Clinic of Restorative and Interventional Neurology and Therapy [3]School of Biomedicine,Far Eastern Federal University

出　　处：《World Journal of Transplantation》2015年第3期110-128,共19页世界移植杂志

摘　　要：AIM: To evaluate the short and long-term effects of the complex cell therapy of 202 cases of spinal cord injury(SCI).METHODS: The main arm included 202 cases of SCI and the control arm included 20 SCI cases. For the therapy the hematopoietic stem cells(HSCs) and progenitor cells(PCs) were mobilized to peripheral blood by 8 subcutaneous injections of granulocyte colonystimulating factor(G-CSF) for 4 d and are harvested at day 5. The cells were administered to the main arm intrathecally every 3 mo for a long term(3-5 years) according to the internal research protocol international medical institute of tissue engineering. Magnetic resonance imaging of the site of injury and urodyna-mic tests were performed every 6 mo. Motor evoked potentials(MEP), somatosensory evoked potentials(SSEP) were evaluated every 3 mo. The patients were evaluated with american spianl injury association(ASIA) index, functional independence measure index, the Medical Research Council Scale, the International Standards for Neurological Classification of Spinal Cord Injury(ISCSCI-92) and specifically developed scales. The function of bladder was evaluated by a specifically developed clinical scale. The long-term clinical outcomes were assessed for the SCI patients who received no less than 20 intrathecal transplantations of HSCs and hematopoietic precursors(HPs).RESULTS: The restoration of neurologic deficit after HSCs and HPs transplantations was proved stable and evident in 57.4% of the cases. In 42.6% cases no neurologic improvement has been observed. In 50% of the cases the motor restoration began after the first transplantation, which is confirmed in average by 9.9 points improvement in neurologic impairment as compared to the baseline(P < 0.05). Repair of the urinary system was observed in 47.7% of the cases. The sensitivity improved from baseline 124.3 points to 138.4 after the first and to 153.5 points after the second transplantations of HSCs and HPs(P < 0.05, between the stages of research). The evaluation with ASIA index demonstratedAIM: To evaluate the short and long-term effects of the complex cell therapy of 202 cases of spinal cord injury(SCI).METHODS: The main arm included 202 cases of SCI and the control arm included 20 SCI cases. For the therapy the hematopoietic stem cells(HSCs) and progenitor cells(PCs) were mobilized to peripheral blood by 8 subcutaneous injections of granulocyte colonystimulating factor(G-CSF) for 4 d and are harvested at day 5. The cells were administered to the main arm intrathecally every 3 mo for a long term(3-5 years) according to the internal research protocol international medical institute of tissue engineering. Magnetic resonance imaging of the site of injury and urodyna-mic tests were performed every 6 mo. Motor evoked potentials(MEP), somatosensory evoked potentials(SSEP) were evaluated every 3 mo. The patients were evaluated with american spianl injury association(ASIA) index, functional independence measure index, the Medical Research Council Scale, the International Standards for Neurological Classification of Spinal Cord Injury(ISCSCI-92) and specifically developed scales. The function of bladder was evaluated by a specifically developed clinical scale. The long-term clinical outcomes were assessed for the SCI patients who received no less than 20 intrathecal transplantations of HSCs and hematopoietic precursors(HPs).RESULTS: The restoration of neurologic deficit after HSCs and HPs transplantations was proved stable and evident in 57.4% of the cases. In 42.6% cases no neurologic improvement has been observed. In 50% of the cases the motor restoration began after the first transplantation, which is confirmed in average by 9.9 points improvement in neurologic impairment as compared to the baseline(P < 0.05). Repair of the urinary system was observed in 47.7% of the cases. The sensitivity improved from baseline 124.3 points to 138.4 after the first and to 153.5 points after the second transplantations of HSCs and HPs(P < 0.05, between the stages of research). The evaluation with ASIA index demonstrated

关 键 词：Spinal CORD injury PARAPLEGIA TETRAPLEGIA HEMATOPOIETIC STEM CELLS STEM CELLS Cell therapy 

分 类 号：R[医药卫生]