Preliminary study of autologous bone marrow nucleated cells transplantation in children with spinal cord injury.
The objective of this study was to assess the safety and efficacy of transplanting bone marrow nucleated cells (BMNCs) to treat children with complete interruption of spinal cord (SC) continuity. The present study was conducted from 2005 to 2011. The inclusion criteria were a magnetic resonance imaging-confirmed complete interruption of SC continuity and no improvement in neurological status within 6 months after standard therapy. Bone marrow was isolated from the iliac ala and submitted to BMNC isolation. Subsequently, the cell suspension was administered into the SC cavity and intravenously. In total, 18 of 19 intraspinal and intravenous BMNC transplantation procedures performed caused no adverse events. One case was connected with transient bradycardia. The experimental therapy showed no late complications in the 1- to 6-year follow-up evaluation period. Neurological improvement was observed in two patients who received multiple implantations. One patient demonstrated improved superficial sensation from Th3 to Th12/L1 and a restored bladder-filling sensation. In the other case, superficial sensation was improved from C2 to C5, and the respiratory drive, the swallowing reflex, and tongue movements were restored. Spasticity and quality of life were improved in three of five patients. In addition, skin pressure ulcers healed and did not recur. Our preliminary results demonstrate the safety and feasibility of BMNC transplantation in children with complete SC injury. The results indicate that a certain degree of neurological and quality-of-life improvement can be attained by children with chronic complete SC injury who receive multiple BMNC implantations.
Departments of Transplantation and Children's Neurosurgery, Jagiellonian University School of Medicine, Cracow, Poland.
Danuta
D
Jarocha
Olga
O
Milczarek
Zdzislaw
Z
Kawecki
Anna
A
Wendrychowicz
Stanislaw
S
Kwiatkowski
Marcin
M
Majka
D001854:Bone Marrow Cells / Q000166:cytology* / Q000502:physiology; D016026:Bone Marrow Transplantation; D064987:Cell- and Tissue-Based Therapy / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007085:Ilium / Q000166:cytology; D007275:Injections, Intravenous; D007278:Injections, Spinal; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009416:Nerve Regeneration / Q000502:physiology*; D013119:Spinal Cord Injuries / Q000473:pathology / Q000628:therapy*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
Cell therapy; Cell transplantation; Spinal cord injury; Tissue regeneration; Transplantation