title: Long-Term Follow-Up of Patients After Autologous Bone Marrow Cell Infusion for Decompensated Liver Cirrhosis.
abstract: Although several human clinical trials using various bone marrow-derived cell types for cirrhotic or decompensated patients have reported a short-term benefit, long-term follow-up data are limited. We analyzed the long-term clinical outcomes of autologous bone marrow cell infusion (ABMI) for decompensated liver cirrhosis (LC). Patients enrolled in a pilot single-armed ABMI study were followed up more than 5 years. Bone marrow-derived mononuclear cells (BM-MNCs) from decompensated LC were harvested and after processing were infused into a peripheral vein. The laboratory test results and long-term clinical course including liver transplantation (LT), development of cancer, cause of death, and survival after ABMI were analyzed. Nineteen patients were followed up for a median of 66 months after ABMI. Liver function, including serum levels of albumin and Child-Pugh (CP) score, was improved at the 1-year follow-up. Liver volume was significantly greater, cirrhosis was sustained, and collagen content was decreased at the 6-month follow-up. Five years after ABMI, five patients (26.3%) maintained CP class A without LT or death, and five patients (26.3%) had undergone elective LT. Hepatocellular carcinoma (HCC) occurred in five patients (26.3%), and lymphoma and colon cancer occurred in one patient each. Three patients (15.8%) were lost to follow-up at months 22, 31, and 33, respectively, but maintained CP class A until their last follow-up. Five patients expired due to infection. While improved liver function was maintained in some patients for more than 5 years after ABMI, other patients developed HCC. Further studies of long-term follow-up cohorts after cell therapy for LC are warranted.
authors.forename: Ja Kyung
authors.initials: JK
authors.lastname: Kim
authors.forename: Soo-Jeong
authors.initials: SJ
authors.lastname: Kim
authors.forename: Yuri
authors.initials: Y
authors.lastname: Kim
authors.forename: Yong Eun
authors.initials: YE
authors.lastname: Chung
authors.forename: Young Nyun
authors.initials: YN
authors.lastname: Park
authors.forename: Hyun Ok
authors.initials: HO
authors.lastname: Kim
authors.forename: Jin Seok
authors.initials: JS
authors.lastname: Kim
authors.forename: Mi-Suk
authors.initials: MS
authors.lastname: Park
authors.forename: Isao
authors.initials: I
authors.lastname: Sakaida
authors.forename: Do Young
authors.initials: DY
authors.lastname: Kim
authors.forename: Jung Il
authors.initials: JI
authors.lastname: Lee
authors.forename: Sang Hoon
authors.initials: SH
authors.lastname: Ahn
authors.forename: Kwan Sik
authors.initials: KS
authors.lastname: Lee
authors.forename: Kwang-Hyub
authors.initials: KH
authors.lastname: Han
mesh_terms: D000293:Adolescent; D000328:Adult; D053687:Adult Stem Cells / Q000166:cytology / Q000502:physiology; D000368:Aged; D001854:Bone Marrow Cells / Q000166:cytology* / Q000502:physiology; D016026:Bone Marrow Transplantation / Q000379:methods; D006801:Humans; D008099:Liver / Q000166:cytology / Q000473:pathology; D008103:Liver Cirrhosis / Q000628:therapy*; D008115:Liver Regeneration / Q000502:physiology; D008875:Middle Aged; D014182:Transplantation, Autologous / Q000379:methods*; D055815:Young Adult