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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 of UPN 9. Fine motor-adaptive and personal-social function in DDST-II improved after 3 months. Walking, running, and total functional scores increased in GMFM. All factors in PEDI-caregiver assistance slightly improved. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.
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Figure 3: Neurodevelopmental evaluation of UPN 9. Fine motor-adaptive and personal-social function in DDST-II improved after 3 months. Walking, running, and total functional scores increased in GMFM. All factors in PEDI-caregiver assistance slightly improved. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.

Mentions: This child was a preterm baby with hypoxic-ischemic encephalopathy, displaying weakness on his left side with periventricular leukomalacia. Fine motor-adaptive function such as circle drawing and personal-social functioning such as independent dressing improved 3 months after CB infusion, and this was followed at 6 months by improvements in brushing teeth and following the rules of games, as well as gross motor functions on the DDST-II scale. Walking, running, and standing abilities, along with total scores in the GMFM, increased consistently. In PEDI-functional skills, mobility, self-care, and social function remained stationary for 3 months after CB infusion. In PEDI-caregiver assistance, all factors increased slightly after 2 months (Figure 3). In the analysis of MRI-DTI, we noted an increment of FA value in the right periventricular white matter. Perfusion in left thalamus was reduced in the baseline SPECT images, but improved in subsequent SPECT images.


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 of UPN 9. Fine motor-adaptive and personal-social function in DDST-II improved after 3 months. Walking, running, and total functional scores increased in GMFM. All factors in PEDI-caregiver assistance slightly improved. 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 3: Neurodevelopmental evaluation of UPN 9. Fine motor-adaptive and personal-social function in DDST-II improved after 3 months. Walking, running, and total functional scores increased in GMFM. All factors in PEDI-caregiver assistance slightly improved. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.
Mentions: This child was a preterm baby with hypoxic-ischemic encephalopathy, displaying weakness on his left side with periventricular leukomalacia. Fine motor-adaptive function such as circle drawing and personal-social functioning such as independent dressing improved 3 months after CB infusion, and this was followed at 6 months by improvements in brushing teeth and following the rules of games, as well as gross motor functions on the DDST-II scale. Walking, running, and standing abilities, along with total scores in the GMFM, increased consistently. In PEDI-functional skills, mobility, self-care, and social function remained stationary for 3 months after CB infusion. In PEDI-caregiver assistance, all factors increased slightly after 2 months (Figure 3). In the analysis of MRI-DTI, we noted an increment of FA value in the right periventricular white matter. Perfusion in left thalamus was reduced in the baseline SPECT images, but improved in subsequent SPECT images.

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