Outcomes of Bone Marrow-Derived Mononuclear Cell Transplantation for Patients in Persistent Vegetative State After Drowning: Report of Five Cases.

Autor:	Liem NT; Vinmec Research Institute of Stem Cell and Gene Technology (VRISG), Vinmec Health Care System, Hanoi, Vietnam.; College of Health Sciences, VinUniversity, Hanoi, Vietnam., Chinh VD; Vinmec Times City International Hospital, Vinmec Healthcare System, Hanoi, Vietnam., Phuong DTM; Vinmec Research Institute of Stem Cell and Gene Technology (VRISG), Vinmec Health Care System, Hanoi, Vietnam.; College of Health Sciences, VinUniversity, Hanoi, Vietnam., Van Doan N; Vinmec Times City International Hospital, Vinmec Healthcare System, Hanoi, Vietnam., Forsyth NR; Institute for Science & Technology in Medicine, Keele University, Keele, United Kingdom., Heke M; Department of Biology, Stanford University, Stanford, CA, United States., Thi PAN; Vinmec Times City International Hospital, Vinmec Healthcare System, Hanoi, Vietnam., Nguyen XH; Vinmec Research Institute of Stem Cell and Gene Technology (VRISG), Vinmec Health Care System, Hanoi, Vietnam.; College of Health Sciences, VinUniversity, Hanoi, Vietnam.
Jazyk:	angličtina
Zdroj:	Frontiers in pediatrics [Front Pediatr] 2020 Sep 10; Vol. 8, pp. 564. Date of Electronic Publication: 2020 Sep 10 (Print Publication: 2020).
DOI:	10.3389/fped.2020.00564
Abstrakt:	Aim: Anoxic brain injury (ABI) due to non-fatal drowning may cause persistent vegetative state (VS) that is currently incurable. The aim of this paper is to present the safety and feasibility of autologous bone marrow-derived mononuclear cell (BMMNC) transplantation in five drowning children surviving in persistent VS. Methods: We used BMMNC as a novel candidate therapeutic tool in a pilot phase-I study for five patients affected by neurological sequelae after near-death drowning. Autologous BMMNCs were freshly isolated using Ficoll gradient centrifugation then infused intrathecally to five patients. The number of transplantation varied from two to four times depending on the motor function improvement of patient after transplantation. Clinical therapeutic effects were evaluated using gross motor function measure and muscle spasticity rating scales, cognitive assessments, and brain MRI before and after cell administrations. Results: Six months after BMMNC transplantation, no serious complications or adverse events were reported. All five patients displayed improvement across the major parameters of gross motor function, cognition, and muscle spasticity. Three patients displayed improved communication including the expression of words. In particular, one patient remarkably reduced cerebral atrophy, with nearly normal cerebral parenchyma after BMMNC transplantation. Conclusions: Autologous BMMNC transplantation for the treatment of children in persistent VS after drowning is safe, feasible, and can potentially improve motor function and cognition and reduce muscle spasticity. These results pave the way for a future phase II clinical trial to evaluate the efficacy of the therapy. (Copyright © 2020 Liem, Chinh, Phuong, Van Doan, Forsyth, Heke, Thi and Nguyen.)
Databáze:	MEDLINE
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