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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 13. By 1 month after cord blood infusion, language had improved, and in DDST-II there were step-wise increments in fine motor-adaptive functions and personal-social skills in the following months. In GMFM, standing definitely improved after the third month. In PEDI, all scores increased gradually. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.
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Figure 6: Neurodevelopmental evaluation of UPN 13. By 1 month after cord blood infusion, language had improved, and in DDST-II there were step-wise increments in fine motor-adaptive functions and personal-social skills in the following months. In GMFM, standing definitely improved after the third month. In PEDI, all scores increased gradually. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.

Mentions: This male child was diplegic and preterm with periventricular leukomalacia. One month after CB infusion language improved, and fine motor-adaptive functions followed after the second month. After the third month, personal-social skills including ability to undress, dress, brush teeth with help, put on a shirt and say the names of friends improved in DDST-II. In GMFM, standing improved dramatically, along with improvements in crawling and kneeling, as well as walking and running, after the third month. He was able to attempt to stand on alternate feet. In PEDI, all scales increased gradually. Improvements were achieved in using utensils, maintaining self-hygiene, bathing, bowel and bladder management, and problem-solving ability and time-orientation also improved (Figure 6). In the analysis of MRI-DTI, an increment of FA values in the right temporal area was noted. There was reduced perfusion in the right thalamus in the baseline SPECT image, and perfusion worsened in the bilateral thalamus in the 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 13. By 1 month after cord blood infusion, language had improved, and in DDST-II there were step-wise increments in fine motor-adaptive functions and personal-social skills in the following months. In GMFM, standing definitely improved after the third month. In PEDI, all scores increased gradually. 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 6: Neurodevelopmental evaluation of UPN 13. By 1 month after cord blood infusion, language had improved, and in DDST-II there were step-wise increments in fine motor-adaptive functions and personal-social skills in the following months. In GMFM, standing definitely improved after the third month. In PEDI, all scores increased gradually. DDST-II; Denver developmental screening test II, PEDI; pediatric evaluation of disability inventory, GMFM; Gross motor function measure-88.
Mentions: This male child was diplegic and preterm with periventricular leukomalacia. One month after CB infusion language improved, and fine motor-adaptive functions followed after the second month. After the third month, personal-social skills including ability to undress, dress, brush teeth with help, put on a shirt and say the names of friends improved in DDST-II. In GMFM, standing improved dramatically, along with improvements in crawling and kneeling, as well as walking and running, after the third month. He was able to attempt to stand on alternate feet. In PEDI, all scales increased gradually. Improvements were achieved in using utensils, maintaining self-hygiene, bathing, bowel and bladder management, and problem-solving ability and time-orientation also improved (Figure 6). In the analysis of MRI-DTI, an increment of FA values in the right temporal area was noted. There was reduced perfusion in the right thalamus in the baseline SPECT image, and perfusion worsened in the bilateral thalamus in the 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