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Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy.

Lee YH, Choi KV, Moon JH, Jun HJ, Kang HR, Oh SI, Kim HS, Um JS, Kim MJ, Choi YY, Lee YJ, Kim HJ, Lee JH, Son SM, Choi SJ, Oh W, Yang YS - J Transl Med (2012)

Bottom Line: Diverse neurological domains improved in 5 patients (25%) as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI.The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia.Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Rehabilitation Medicine, Hanyang University Medical Center, Seoul, Korea.

ABSTRACT

Backgrounds: We conducted a pilot study of the infusion of intravenous autologous cord blood (CB) in children with cerebral palsy (CP) to assess the safety and feasibility of the procedure as well as its potential efficacy in countering neurological impairment.

Methods: Patients diagnosed with CP were enrolled in this study if their parents had elected to bank their CB at birth. Cryopreserved CB units were thawed and infused intravenously over 10~20 minutes. We assessed potential efficacy over 6 months by brain magnetic resonance imaging (MRI)-diffusion tensor imaging (DTI), brain perfusion single-photon emission computed tomography (SPECT), and various evaluation tools for motor and cognitive functions.

Results: Twenty patients received autologous CB infusion and were evaluated. The types of CP were as follows: 11 quadriplegics, 6 hemiplegics, and 3 diplegics. Infusion was generally well-tolerated, although 5 patients experienced temporary nausea, hemoglobinuria, or urticaria during intravenous infusion. Diverse neurological domains improved in 5 patients (25%) as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI. The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia.

Conclusions: Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.

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Related in: MedlinePlus

Neurodevelopmental evaluation in UPN 8. One month after cord blood infusion, personal-social, fine motor-adaptive, and language scores in DDST-II improved. In GMFM, most domains improved gradually, while in PEDI, social function improved slightly. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.
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Figure 1: Neurodevelopmental evaluation in UPN 8. One month after cord blood infusion, personal-social, fine motor-adaptive, and language scores in DDST-II improved. In GMFM, most domains improved gradually, while in PEDI, social function improved slightly. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.

Mentions: This child had functional hemiplegia and polymicrogyria on conventional brain MRI. One month after CB infusion, she improved on the personal-social, fine motor-adaptive, and language scales of DDST-II. She became able to dress herself and brush her teeth on the personal-social scale of DDST-II. Her score on the fine motor adaptive scale increased markedly in three months. She could make piles of 6 to 8 blocks, and was able to draw straight lines and circles. In GMFM, her balance while standing was enhanced as was her ability to jump over sticks and stand on one foot. In terms of PEDI-functional skills, she showed increased mobility and a slight improvement in social function. She also had slightly increased self-care, mobility, and social function in terms of problem solving, self-awareness and time orientation in the PEDI-caregiver assistant scale (Figure 1). In the analysis of MRI-DTI, we noted increments of FA values in the right temporal area, among the three significant areas. She displayed decreased perfusion in the left thalamus and right basal ganglia in the baseline SPECT study, and improved perfusion in these areas in subsequent brain perfusion SPECT images (Figure 2).


Safety and feasibility of countering neurological impairment by intravenous administration of autologous cord blood in cerebral palsy.

Lee YH, Choi KV, Moon JH, Jun HJ, Kang HR, Oh SI, Kim HS, Um JS, Kim MJ, Choi YY, Lee YJ, Kim HJ, Lee JH, Son SM, Choi SJ, Oh W, Yang YS - J Transl Med (2012)

Neurodevelopmental evaluation in UPN 8. One month after cord blood infusion, personal-social, fine motor-adaptive, and language scores in DDST-II improved. In GMFM, most domains improved gradually, while in PEDI, social function improved slightly. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3369209&req=5

Figure 1: Neurodevelopmental evaluation in UPN 8. One month after cord blood infusion, personal-social, fine motor-adaptive, and language scores in DDST-II improved. In GMFM, most domains improved gradually, while in PEDI, social function improved slightly. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.
Mentions: This child had functional hemiplegia and polymicrogyria on conventional brain MRI. One month after CB infusion, she improved on the personal-social, fine motor-adaptive, and language scales of DDST-II. She became able to dress herself and brush her teeth on the personal-social scale of DDST-II. Her score on the fine motor adaptive scale increased markedly in three months. She could make piles of 6 to 8 blocks, and was able to draw straight lines and circles. In GMFM, her balance while standing was enhanced as was her ability to jump over sticks and stand on one foot. In terms of PEDI-functional skills, she showed increased mobility and a slight improvement in social function. She also had slightly increased self-care, mobility, and social function in terms of problem solving, self-awareness and time orientation in the PEDI-caregiver assistant scale (Figure 1). In the analysis of MRI-DTI, we noted increments of FA values in the right temporal area, among the three significant areas. She displayed decreased perfusion in the left thalamus and right basal ganglia in the baseline SPECT study, and improved perfusion in these areas in subsequent brain perfusion SPECT images (Figure 2).

Bottom Line: Diverse neurological domains improved in 5 patients (25%) as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI.The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia.Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.

View Article: PubMed Central - HTML - PubMed

Affiliation: Department of Rehabilitation Medicine, Hanyang University Medical Center, Seoul, Korea.

ABSTRACT

Backgrounds: We conducted a pilot study of the infusion of intravenous autologous cord blood (CB) in children with cerebral palsy (CP) to assess the safety and feasibility of the procedure as well as its potential efficacy in countering neurological impairment.

Methods: Patients diagnosed with CP were enrolled in this study if their parents had elected to bank their CB at birth. Cryopreserved CB units were thawed and infused intravenously over 10~20 minutes. We assessed potential efficacy over 6 months by brain magnetic resonance imaging (MRI)-diffusion tensor imaging (DTI), brain perfusion single-photon emission computed tomography (SPECT), and various evaluation tools for motor and cognitive functions.

Results: Twenty patients received autologous CB infusion and were evaluated. The types of CP were as follows: 11 quadriplegics, 6 hemiplegics, and 3 diplegics. Infusion was generally well-tolerated, although 5 patients experienced temporary nausea, hemoglobinuria, or urticaria during intravenous infusion. Diverse neurological domains improved in 5 patients (25%) as assessed with developmental evaluation tools as well as by fractional anisotropy values in brain MRI-DTI. The neurologic improvement occurred significantly in patients with diplegia or hemiplegia rather than quadriplegia.

Conclusions: Autologous CB infusion is safe and feasible, and has yielded potential benefits in children with CP.

Show MeSH
Related in: MedlinePlus