[Functional improvement of patients with progressive muscular dystrophy by bone marrow and umbilical cord blood mesenchymal stem cell transplantations].

OBJECTIVE: To investigate the feasibility of employing double transplantations of autologous bone marrow mesenchymal stem cells (BMSC) and umbilical cord mesenchymal stem cells (UMSC) in the treatment of progressive muscular dystrophy (PMD). METHODS: A total of 82 cases were treated by the double transplantations of BMSC and CB-MSC. They were diagnosed by clinical manifestations, CK, LDH, genetic analysis, electromyography, MRI and pathologic examination of biopsied muscle specimens from July 2007 to July 2008. Control group was self-made at before and after treatment and cases were followed up for 3 - 12 months. treatment method: Eighty-two patients underwent the double transplantations of bone mesenchymal stem cell (BMSC) and human umbilical cord blood MSC (CB-MSC). (1) BMSC: 80 - 150 ml bone marrow sample was collected through a puncture at bilateral posterior superior iliac spine. Ficoll density gradient centrifuge was employed to separate individual monocyte for induced differentiation. (2) CB-MSC: 80 - 160 ml umbilical cord blood was harvested and processed likewise as above. (3) Stem cell transplantation: Both BMSC and CB-MSC were collected and prepared into 1 x 10(8)/ml and 1 x 10(7)/ml cell suspension respectively. They were transplanted in divided does into the extremity muscle and vein. The clinical and laboratory parameters were monitored at 3, 6, 9 and 12 months. RESULTS: It was found that 31 cases (37.8%) obtained a remarkable efficacy, 37 cases (45.1%) were effective and 14 cases (17.1%) had no change. Total effective rate was 82.9%. Seventy patients (85.4%) felt limbs warmly, appetite improved, gained weight, had better appetite and action were nimble. Activity of daily living scale (ADL) in 72 patients (87.8%) increased as compared with pre-treatment (P < 0.01). LDH decreased at post-treatment [(475 +/- 223) u/L vs (410 +/- 216) u/L, P < 0.05, t = 6.650]. Creatine kinase [(2952 +/- 2259) u/L vs (2841 +/- 2092) u/L, P = 0.223, t = 1.094] and creatine [(26 +/- 12) micromol/L vs (25 +/- 11) micromol/L, P = 0.306, t = 1.029] decreased slightly. Adherence to therapy among Children and no adverse reaction was reported during the course of treatment. CONCLUSION: The double transplantation of BMSC and CB-MSC is convenient, safe and effective in the treatment of progressive muscular dystrophy and can be considered as a new therapy of PMD. MSC represents a possible tool of cellular therapeutics for PMD.

[Clinical study on the improvement of ischemia condition with stem cell transplantation in 122 cases necrosis of femoral head].

OBJECTIVE: To observe the curative effects of bone marrow stem cell (BMSC) and peripheral blood stem cell (PBSC) transplantations on the avascular necrosis of femoral head (ANFH). METHODS: Totally 122 ANFH patients (211 coxae) treated by BMSC or PBSC transplantations were enrolled from July 2004 to December 2006. All of them were classed to different stages according to the ARCO. Control group were desired as themselves before and after treatment. The puncture of femoral artery was conducted with digital subtraction angiography (DSA), and the tubes were inserted into medial femoral circumflex artery, lateral femoral circumflex artery and obturator artery with the cell suspensions were gradually poured into the arteries. RESULTS: The joint pain, joint functions and walking distance of 122 patients were detected for the follow-up. Compared with before treatment, the calibers thickened; vessels increased and blood velocity quickened of femoral head blood-supply artery were observed in 15 patients after 6 months checked by DSA. The reduced areas of femoral head necrosis in 8 patients indicated the new bone formation between 12 and 24 months. CONCLUSIONS: Autologous BMSC and PBSC transplantation results in the new bone formation and improvement of ischemia in areas of femoral head necrosis at 6 months. The change of angiography was observed about 12 to 24 months after cell transplantation. The stem cell transplantation is convenient, safe and effective in the treatment of the ANFH with no adverse reaction, and can be considered as a new therapy of ANFH.

[Significance of serological test of blood group in nonmyeloablative allogeneic peripheral blood stem cell transplantation of patients with acute leukemia].

The purpose of this study is to explore the clinical significance of RBC blood group serological test in nonmyeloablative allogeneic peripheral blood stem cell transplantation (NAPBSCT) of ABO group incompatibility in 4 patients with acute leukemia. ABO and MN blood group of donors and recipients were determined by hemagglutination test and Rh blood group by Diana Gel phenotype Rh card. The changes of blood group in recipients were observed and implant of donor cells was monitored by short tandem repeat-PCR method. The results showed that in 2 cases of 4 recipients the marrow cells appeared mixed chimera of donor and recipient cells, and blood group changed to donor type in 1 of the 2 cases on 100 days after transplantation. In another 2 cases, the marrow cells appeared mixed chimera without blood group chimera on 154 days after transplantation, and rejection of the transplant occurred in 1 of the 2 cases. The determination of hemagglutinin titer showed that the implant rate of donor cells was lower in the recipients with higher hemagglutinin titer and blood group chimera did not appear, conversely, the implant rate was higher in the recipients with lower titer and blood group chimera appeared early. It is concluded that examination of RBC blood group in NAPB SCT can indirectly reflect effectiveness of transplantation, contribute to decide the intensity of conditioning protocol and immunosuppressive therapy after transplantation, estimate prognosis and guide blood transfusion during transplantation.