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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 11. In DDST-II, the personal-social score increased dramatically by 1 month after infusion and fine motor-adaptive function also increased by 3 months after infusion. In PEDI, self-care and social function gradually increased. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.
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Figure 4: Neurodevelopmental evaluation of UPN 11. In DDST-II, the personal-social score increased dramatically by 1 month after infusion and fine motor-adaptive function also increased by 3 months after infusion. In PEDI, self-care and social function gradually increased. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.

Mentions: This little girl was hemiplegic with no defined cause. Scores on the personal-social scale in DDST-II, in skills such as brushing teeth with assistance, undressing, using fork and spoon, and tidying toys, increased dramatically 1 month after CB infusion, and fine motor-adaptive activities such as tapping an object with either hand, picking a plum from a bottle and piling up pairs of blocks began to increase after 2 months. Standing ability in GMFM increased after the second month, and there was a gradual increase in functional skills and caregiver assistance in PEDI self-care activities such as using utensils, grooming, washing her face and bowel management, and in social functions including language comprehension and playing with toys (Figure 4). In the analysis of MRI-DTI, an increment of FA values in the right posterior periventricular white matter and right periventricular white matter was noted. Perfusion in the left posterior frontal and upper temporal cortexes, left basal ganglia, left thalamus and left cerebellum was reduced in the baseline SPECT images, and did not change significantly 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 11. In DDST-II, the personal-social score increased dramatically by 1 month after infusion and fine motor-adaptive function also increased by 3 months after infusion. In PEDI, self-care and social function gradually increased. 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 4: Neurodevelopmental evaluation of UPN 11. In DDST-II, the personal-social score increased dramatically by 1 month after infusion and fine motor-adaptive function also increased by 3 months after infusion. In PEDI, self-care and social function gradually increased. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.
Mentions: This little girl was hemiplegic with no defined cause. Scores on the personal-social scale in DDST-II, in skills such as brushing teeth with assistance, undressing, using fork and spoon, and tidying toys, increased dramatically 1 month after CB infusion, and fine motor-adaptive activities such as tapping an object with either hand, picking a plum from a bottle and piling up pairs of blocks began to increase after 2 months. Standing ability in GMFM increased after the second month, and there was a gradual increase in functional skills and caregiver assistance in PEDI self-care activities such as using utensils, grooming, washing her face and bowel management, and in social functions including language comprehension and playing with toys (Figure 4). In the analysis of MRI-DTI, an increment of FA values in the right posterior periventricular white matter and right periventricular white matter was noted. Perfusion in the left posterior frontal and upper temporal cortexes, left basal ganglia, left thalamus and left cerebellum was reduced in the baseline SPECT images, and did not change significantly 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