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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 12. All functions except gross motor in DDST-II improved by 2 months after infusion. Walking and running steadily improved in GMFM. Self-care, mobility, and social functions increased gradually on PEDI-caregiver assistance scale. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.
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Figure 5: Neurodevelopmental evaluation of UPN 12. All functions except gross motor in DDST-II improved by 2 months after infusion. Walking and running steadily improved in GMFM. Self-care, mobility, and social functions increased gradually on PEDI-caregiver assistance scale. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.

Mentions: This little girl was a preterm baby with hypoxic-ischemic encephalopathy, and displayed weakness on her left side with periventricular leukomalacia. All functions except gross motor function in DDST-II improved by 2 months after CB infusion. She could dress herself and follow the rules of games on the personal-social scale, and was also able to use building blocks, draw circles, drawing a person and distinguish two straight lines on the fine motor-adaptive scale. Language improved markedly after the first month. She became able to understand the identities of objects, prepositions and adjectives on the language scale. Walking and running gradually improved on GMFM, and all tests showed a gradual increase in PEDI-functional skills. Self-care, mobility, and social function increased dramatically on the PEDI-caregiver assistance scale (Figure 5). In the analysis of MRI-DTI, increments of FA values in the right temporal and corpus callosum were noted. There was decreased perfusion in the bilateral anterior medial frontal cortex, and a suspicion of decreased perfusion in the bilateral thalamus on the baseline SPECT images, and this was followed by a definite decrease of perfusion in the bilateral thalamus on 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 12. All functions except gross motor in DDST-II improved by 2 months after infusion. Walking and running steadily improved in GMFM. Self-care, mobility, and social functions increased gradually on PEDI-caregiver assistance scale. 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 5: Neurodevelopmental evaluation of UPN 12. All functions except gross motor in DDST-II improved by 2 months after infusion. Walking and running steadily improved in GMFM. Self-care, mobility, and social functions increased gradually on PEDI-caregiver assistance scale. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; gross motor function measure-88.
Mentions: This little girl was a preterm baby with hypoxic-ischemic encephalopathy, and displayed weakness on her left side with periventricular leukomalacia. All functions except gross motor function in DDST-II improved by 2 months after CB infusion. She could dress herself and follow the rules of games on the personal-social scale, and was also able to use building blocks, draw circles, drawing a person and distinguish two straight lines on the fine motor-adaptive scale. Language improved markedly after the first month. She became able to understand the identities of objects, prepositions and adjectives on the language scale. Walking and running gradually improved on GMFM, and all tests showed a gradual increase in PEDI-functional skills. Self-care, mobility, and social function increased dramatically on the PEDI-caregiver assistance scale (Figure 5). In the analysis of MRI-DTI, increments of FA values in the right temporal and corpus callosum were noted. There was decreased perfusion in the bilateral anterior medial frontal cortex, and a suspicion of decreased perfusion in the bilateral thalamus on the baseline SPECT images, and this was followed by a definite decrease of perfusion in the bilateral thalamus on 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