RESUMO
This article describes the results of systemic transplantations of cardiomyoblasts grown from autologous or allogeneic bone marrow-derived mesenchymal stem cells, in the complex therapy of the late radiation da- mage of the heart, which developed after radiation therapy in 16 female patients with Hodgkin disease (HD) or breast cancer (BC). The cell therapy drastically improved the efficacy of the drug treatment, which earlier was the only option for the therapy of the radiation damage of vital organs. The effect of such therapy was clinically observed in the patients already in the first year of observation, and consisted in the decrease of the degree of the cardiac failure severity and improvement of their quality of life in the absence of HD or BC progression.
Assuntos
Terapia Baseada em Transplante de Células e Tecidos/métodos , Traumatismos Cardíacos/terapia , Transplante de Células-Tronco Mesenquimais/métodos , Lesões por Radiação/terapia , Adulto , Animais , Transplante de Medula Óssea/métodos , Neoplasias da Mama/complicações , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Diferenciação Celular/efeitos da radiação , Feminino , Traumatismos Cardíacos/etiologia , Doença de Hodgkin/complicações , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Pessoa de Meia-Idade , Miócitos Cardíacos/citologia , Miócitos Cardíacos/transplante , Qualidade de Vida , Lesões por Radiação/etiologia , Lesões por Radiação/patologia , Radioterapia/efeitos adversos , Transplante AutólogoRESUMO
The use of triple systemic transplantation of cardiomyoblasts raised from the culture of allogenic bone marrow mesenchymal stem cells of a healthy donor according to the new medical technology licensed by Federal Service on Surveillance in Healthcare in the therapy of a patient with late radiation cardiomyopathy and radiation exudative pericarditis developed 45 years after radiation therapy for Hodgkin lymphoma. High efficiency of systemic transplantation of mesenchymal stem cells partially differentiated towards cardiomyocytes was demonstrated. The therapeutic effect persists for more than 2 years. Possible mechanisms of the therapeutic effect of this type of stem cells and the prospects of using cell therapy in the treatment of late radiation injuries of vital organs and tissues are discussed.
Assuntos
Cardiomiopatias/terapia , Transplante de Células-Tronco Mesenquimais , Mioblastos Cardíacos/transplante , Pericardite/terapia , Cardiomiopatias/diagnóstico por imagem , Cardiomiopatias/etiologia , Cardiomiopatias/patologia , Diferenciação Celular , Raios gama/efeitos adversos , Doença de Hodgkin/complicações , Doença de Hodgkin/diagnóstico por imagem , Doença de Hodgkin/patologia , Doença de Hodgkin/radioterapia , Humanos , Masculino , Células-Tronco Mesenquimais/citologia , Células-Tronco Mesenquimais/fisiologia , Pessoa de Meia-Idade , Mioblastos Cardíacos/citologia , Mioblastos Cardíacos/fisiologia , Pericardite/diagnóstico por imagem , Pericardite/etiologia , Pericardite/patologia , Transplante Homólogo , Resultado do Tratamento , UltrassonografiaRESUMO
The objective of this study was to investigate in vivo the dose response of radiation induced chromosomal aberrations in human blood lymphocytes of lung cancer patients given non-uniform fractional exposures to high doses of therapeutic 60Co gamma-rays delivered synchronously with polychemotherapy. The chromosome aberration analysis was carried out in peripheral blood lymphocytes of 13 lung cancer patients who manifested II to IV developmental clinical stage. During the course of radiotherapy they received the accumulated tumor dose ranged 47.5 to 70 Gy. The yield ofdicentrics, centric rings and fragments was measured in the blood samples taken before treatment, after the first day and after the complete course of radiotherapy. Based on cytogenetic measurements of 3 patients, the average tumor dose after the first day was estimated to be 2.1 to 3.0 Gy given that the corresponding physical dose was (1.0 Gy + 1.5 Gy). The quotient of the individual dose estimated by the frequency of aberrations to the physical dose after the complete course of radiotherapy was calculated for all 13 patients. The mean quotient was shown to be equal to 93 +/- 9% ranged 50 to 154%.
Assuntos
Antineoplásicos/toxicidade , Aberrações Cromossômicas , Neoplasias Pulmonares , Linfócitos , Idoso , Antineoplásicos/administração & dosagem , Aberrações Cromossômicas/efeitos dos fármacos , Aberrações Cromossômicas/efeitos da radiação , Isótopos do Cobalto , Relação Dose-Resposta à Radiação , Feminino , Raios gama , Humanos , Neoplasias Pulmonares/tratamento farmacológico , Neoplasias Pulmonares/genética , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/radioterapia , Linfócitos/efeitos dos fármacos , Linfócitos/efeitos da radiação , Masculino , Pessoa de Meia-Idade , Estadiamento de NeoplasiasRESUMO
Possible therapeutic effect of systemic (intravenous) transplantation of autologous mesenchymal stem cells was studied in experiments (C57Bl/6 mice) and pilot clinical trial. Clinical trial was performed on 11 patients with radiation-induced lung injuries developed after combined chemotherapy and radiation therapy for lymphogranulomatosis or breast cancer. The patients were subjected to single transplantation of mesenchymal stem cells and course of standard pharmacotherapy. The method for isolation of autologous mesenchymal stem cells was licensed. The transplantation of mesenchymal stem cells was followed by a decrease in the mortality rate of mice with radiation-induced lung injury. Clinical trial showed that cell therapy with autologous mesenchymal stem cells does not induce progression of the underlying oncological disease. Parameters of spirography, immune status, lung scintigraphy, and markers for inflammation and tissue hypoxia in the patients remained practically unchanged 1 year after the treatment. These clinical signs reflect stabilization of the radiation process.
