title: [Autologous peripheral blood hematopoietic stem cell transplantation in the treatment of type 1 diabetic mellitus: a report of 16 cases].
abstract: OBJECTIVE
  To explore the efficacy and safety of autologous peripheral blood hematopoietic stem cell transplantation (APBHST) in patients with type 1 diabetes mellitus.
  
  
  METHODS
  Hematopoietic stem cells were mobilized with cyclophosphamide and granulocyte colony stimulating factor for 16 patients with type 1 diabetes mellitus who admitted to our department during November 2009 to August 2010. And then stem cells were collected from peripheral blood by leukapheresis and cryopreservation. The cells were infused intravenously after conditioning with cyclophosphamide and antithymocyte globulin. To compare the daily dose of exogenous insulin requirements, the serum levels of hemoglobin A1c (HbA1c), C-peptide, islet cell function during the mixed meal tolerance test were measured before and at different times after APBHST. Blood glucose was monitored 7 times a day before and after APBHST. And the adverse effects were recorded during and after APBHST.
  
  
  RESULTS
  The median follow-up was 28 weeks (range: 8 - 44 weeks). Twelve of 16 patients stayed free from insulin at 3 - 20 days post APBHST. And islet cell function greatly improved after APBHST. Four of 16 patients required exogenous insulin but the dosage decreased. And all 4 patients had a poor level of C-peptide before APBHSCT. There were no such severe adverse effects as myelosuppression.
  
  
  CONCLUSIONS
  Very encouraging results have been obtained in the patients treated with APBHST. There is definite therapeutic effects and safety in a short term. But further follow-up is necessary to confirm the duration of insulin independence and the mechanisms of action.
authors.affiliation: Department of Cellular Therapy, PLA Organ Transplantation Centre, Beijing, China.
authors.forename: Kai
authors.initials: K
authors.lastname: Feng
authors.forename: Yi-wei
authors.initials: YW
authors.lastname: Xu
authors.forename: Fu-guang
authors.initials: FG
authors.lastname: Ye
authors.forename: Li
authors.initials: L
authors.lastname: Xiao
authors.forename: Xi-hui
authors.initials: XH
authors.lastname: Ma
authors.forename: Yu
authors.initials: Y
authors.lastname: Gao
authors.forename: Xin
authors.initials: X
authors.lastname: Zhang
authors.forename: Shang-zhi
authors.initials: SZ
authors.lastname: Yao
authors.forename: Bing-yi
authors.initials: BY
authors.lastname: Shi
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003922:Diabetes Mellitus, Type 1 / Q000601:surgery*; D005260:Female; D018380:Hematopoietic Stem Cell Transplantation / Q000379:methods*; D006801:Humans; D008297:Male; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D055815:Young Adult