Case control series of intrathecal autologous bone marrow mesenchymal stem cell therapy for chronic spinal cord injury.

Abstract:

BACKGROUND:Autologous bone marrow mesenchymal cells that include stem cells (MSCs) are a clinically attractive cellular therapy option to try to treat severe spinal cord injury (SCI). OBJECTIVE:To study the possible value of MSCs injected intrathecally to enhance rehabilitation. METHODS:This case control, convenience sample included 64 patients, at a mean of 3.6 years after SCI. Forty-four subjects received monthly intrathecal autologous MSCs for 6 months and 20 subjects, who would not agree to the procedures, served as controls. All subjects received rehabilitation therapies 3 times weekly. Subjects were evaluated at entry and at 12 months after completing the 6-months intervention. By the ASIA Impairment Scale, ASIA grading of completeness of injury, Ashworth Spasticity Scale, Functional Ambulation Classification, and bladder and bowel control questionnaire. RESULTS:No differences were found in baseline measures and descriptors between the MSC group and control group. Although a higher percentage of the MSC group increased motor scores by 1-2 points and changed from ASIA A to B, no significant between-group improvements were found in clinical measures. Adverse effects of cells included spasticity and, in 24 out of the 43 patients developed neuropathic pain. One subject with a history of post-infectious myelitis developed encephalomyelitis after her third injection. CONCLUSION:Autologus MSCs may have side effects and may be contraindicated in patients with a history of myelitis. Their utility in treating chronic traumatic SCI needs further study in pre-clinical models and in randomized controlled trials before they should be offered to patients.

authors

Kishk NA,Gabr H,Hamdy S,Afifi L,Abokresha N,Mahmoud H,Wafaie A,Bilal D

doi

10.1177/1545968310369801

subject

Has Abstract

pub_date

2010-10-01 00:00:00

pages

702-8

issue

8

eissn

1545-9683

issn

1552-6844

pii

1545968310369801

journal_volume

24

pub_type

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