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1.
Article in English | LILACS, BBO | ID: biblio-1155006

ABSTRACT

ABSTRACT Objective: To evaluate the regeneration of mandibular cartilage defect after implantation of human umbilical cord mesenchymal stem cells (hUCMSC) over platelet rich fibrin (PRF) as scaffold. Material and Methods: 20 male Wistar rats were randomly divided into four experimental groups consisting of: a control group featuring untreated mandibular defects (C), experimental groups whose mandibular defects were implanted with hUCMSC (E1), mandibular defects implanted with PRF (E2), mandibular defects implanted with hUCMSC and PRF scaffold (E3). The subjects were sacrificed after six weeks of observation for immunohistochemical examination in order to evaluate the expression of Ki67, Sox9, FGF 18, type 2 collagen, and aggrecan, in addition to histology examination to evaluate chondrocyte number and cartilage thickness. Data was analyzed with univariate analysis (ANOVA). Results: The implantation of hUCMSC and PRF scaffold proved capable of regenerating mandibular cartilage defect through the expression of FGF 18, Sox9, Ki67, chondrosis counts, type 2 collagen, aggrecan, and cartilage thickness. The regeneration were significantly higher in group E3. Conclusion: Human umbilical cord mesenchymal stem cells in platelet rich fibrin scaffold proved capable of regenerating mandibular cartilage defect.


Subject(s)
Animals , Rats , Cartilage , Cord Blood Stem Cell Transplantation , Regenerative Medicine , Mesenchymal Stem Cells/microbiology , Platelet-Rich Fibrin/microbiology , Immunohistochemistry , Epidemiology, Experimental , Analysis of Variance , Rats, Wistar , Indonesia/epidemiology
2.
Rev. cuba. hematol. inmunol. hemoter ; 36(1): e1090, ene.-mar. 2020. tab
Article in Spanish | LILACS, CUMED | ID: biblio-1126545

ABSTRACT

Introducción: El cordón umbilical se ha convertido en un elemento de interés para la medicina regenerativa en los últimos años, pues constituye una fuente importante de células madres y progenitores hematopoyéticos. Objetivo: Caracterizar morfológicamente la sangre del cordón umbilical para terapia regenerativa en recién nacidos del Hospital Universitario Ginecobstétrico Ana Betancourt de Mora. Métodos: Estudio observacional, analítico y transversal realizado en el Centro de Inmunología y Productos Biológicos de Camagüey, entre enero y diciembre de 2017. Se evaluaron 35 muestras de sangre del cordón umbilical obtenidas de recién nacidos, que fueron partos eutócicos y sus madres no tuvieron procesos de enfermedades infecciosas. Resultados: El promedio mayor de células mononucleares correspondió a los linfocitos. En el conteo diferencial los polimorfonucleares neutrófilos ocuparon el primer lugar, seguido de los linfocitos, con medias de 0,50 y 0,46 x 109/L, respectivamente. De las células presentes en el frotis del botón, fueron más frecuente los linfocitos con 0.59 x 109/L; se observó un promedio de monocitos de 0,00-0,07 x 109/L. Conclusiones: La obtención de células mononucleares viables a través de la vena umbilical, constituye una técnica promisoria en las investigaciones biomédicas. Entre las células mononucleares predominaron los linfocitos, tanto en la sangre del cordón umbilical como en el botón celular aislado(AU)


Introduction: In recent years, the umbilical cord has become an element of interest for regenerative medicine, based on its importance as a source of stem cells and hematopoietic progenitors. Objective: To characterize the morphology of umbilical cord blood for regenerative therapy in newborns from Ana Betancourt de Mora Gyneco-obstetric University Hospital. Methods: Observational, analytical and cross-sectional study carried out at the Center of Immunology and Biological Products in Camagüey, between January and December 2017. We evaluated 35 samples of umbilical cord blood obtained from newborns who were eutocic deliveries and whose mothers did not have infectious disease processes. Results: The highest average of mononuclear cells corresponded to lymphocytes. In the differential count, neutrophil polymorphonuclear cells ranked first, followed by lymphocytes, with averages of 0.50x109 and 0.46x109 per liter, respectively. Of the cells present in the button cell smear, lymphocytes were more frequent, with 0.59x109 per L; an average of monocytes was observed, with 0.00-0.07x109 per L was observed. Conclusions: Obtaining viable mononuclear cells through the umbilical vein is a promising technique in biomedical research. Among the mononuclear cells, lymphocytes predominated, both in the cord blood and in the isolated cell button(AU)


Subject(s)
Humans , Male , Female , Cord Blood Stem Cell Transplantation/methods , Regenerative Medicine/methods , Blood Cell Count/standards , Cross-Sectional Studies
3.
Journal of Experimental Hematology ; (6): 1049-1053, 2020.
Article in Chinese | WPRIM | ID: wpr-827163

ABSTRACT

Abstract  Umbilical cord blood (UCB) is an alternative source of hematopoietic stem cells (HSCs) for patients who were lack of HLA match related or unrelated donors. Compared with bone marrow and mobilized peripheral blood, UCB has the advantages of easy availability, safety for donors, and low requirement for HLA match between donors and recipients. However, the cell amount in UCB is relatively less, which was associated with increased graft failure, delayed hematologic recovery, immune reconstitution, and higher transplant related mortality after UCB transplantation (UCBT). Double-unit UCB is a straightforward method to augment cell amount in UCB. Compared with single-unit UCBT, double-unit CBT associated with less risk of primary disease relapse and increased incidence rate of graft-versus-host disease (GVHD), but the hematologic recovery and overall survival of recipients were no significantly difference between single and double-unit UCBT. Novel strategies for UCB expansion significantly increased the cell amount in UCB, single-unit expanded UCBT not only increased the sources of UCB, but also decreased the high cost of double-unit UCB. ATG can decrease the risk of graft failure and GVHD rate, but the role of ATG in UCBT is still controversial. Herein, the recent clinical advances on UCBT in the treatment of hematologic diseases are systematically reviewed.


Subject(s)
Cord Blood Stem Cell Transplantation , Graft vs Host Disease , Hematologic Diseases , Hematopoietic Stem Cell Transplantation , Humans , Unrelated Donors
4.
Journal of Experimental Hematology ; (6): 1123-1126, 2020.
Article in Chinese | WPRIM | ID: wpr-827152

ABSTRACT

OBJECTIVE@#To explore the clinical efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) in the treatment of Juvenile myelomonocytic leukemia (JMML).@*METHODS@#The clinical data of 5 children with JMML who were treated with unrelated UCBT from October 2011 to July 2019 were retrospectively analyzed. The age of onset for the five children (male) ranged from 0.4 to 5.0 years old, with a median age of 1.5 years old. All the patients received myeloablative conditioning regimen without ATG to whom cyclosporine A (CsA) with short-term mycophenolate mofetil (MMF) was given for GVHD prophylaxis.@*RESULTS@#Four children acquired engraftment. One patient received secondary haploidentical hematopoietic stem cell transplantation because of the failure in the first unrelated UCBT. Grade Ⅲ to Ⅳ aGVHD occurred in 2 cases and was controlled, and none of the patients developed cGVHD. Three cases achieved long-time disease free survival,and no patient relapsed.@*CONCLUSION@#UCBT is an effective treatment for children with JMML.


Subject(s)
Child , Child, Preschool , Cord Blood Stem Cell Transplantation , Graft vs Host Disease , Hematopoietic Stem Cell Transplantation , Humans , Infant , Leukemia, Myelomonocytic, Juvenile , Male , Retrospective Studies , Transplantation Conditioning
5.
Article in Chinese | WPRIM | ID: wpr-774035

ABSTRACT

OBJECTIVE@#To investigate the clinical efficacy of haploid hematopoietic stem cells (haplo-HSC) combined with third-party umbilical cord blood (tpCB) transplantation in the treatment of X-linked chronic granulomatous disease (X-CGD).@*METHODS@#The clinical data of 26 boys with X-CGD were retrospectively analyzed who were admitted to the Sixth Medical Center of PLA General Hospital between April 2014 and March 2018. All the patients were treated with haplo-HSC combined with tpCB transplantation. The median age of the patients was 3.5 years. The donor was the father in 25 cases and an aunt in 1 case. Transplantation was 5/6 HLA-matched in 9 cases, 4/6 in 12 cases, and 3/6 in 5 cases. The patients received busulfan, cyclophosphamide, fludarabine, or anti-thymocyte globulin for myeloablative preconditioning. Cyclosporine A and mycophenolate mofetil were used for prevention of acute graft-versus-host disease (aGVHD). Then the patients were treated with haploid bone marrow hematopoietic stem cells combined with tpCB transplantation on day 1 and haploid peripheral hematopoietic stem cells on day 2. The counts of median donor total nucleated cells, CD34 cells, and CD3 cells were 14.6×10/kg, 5.86×10/kg, and 2.13×10/kg respectively.@*RESULTS@#The median time to neutrophil and platelet engraftment was 12 and 23 days after transplantation respectively. Full donor hematopoietic chimerism was observed on day 30. Twenty-five cases were from haplo-HSC and 1 was from cord blood. No primary implant failure and implant dysfunction occurred, and secondary implant failure occurred in one case. The NADPH oxidase activity returned to normal one month after transplantation. The incidence of grade I-II aGVHD and grade III-IV aGVHD was 35% and 15% respectively. Chronic GVHD (cGVHD) of the skin occurred in one case, and no progression was observed after steroid administration. During the follow-up period of 6-51 months, 25 patients survived, of whom 24 were disease-free (23 patients without cGVHD and 1 with cGVHD of the skin) and NADPH oxidase activity returned to normal; one patient developed secondary implant failure but survived; one patient died of viral interstitial pneumonia 16 months after transplantation. The 5-year event-free survival rate and overall survival rate were 81%±12% and 89%±10% respectively.@*CONCLUSIONS@#Haplo-HSC combined with tpCB transplantation is one of the effective methods for the treatment of X-CGD in children.


Subject(s)
Child, Preschool , Cord Blood Stem Cell Transplantation , Graft vs Host Disease , Granulomatous Disease, Chronic , Haploidy , Hematopoietic Stem Cell Transplantation , Hematopoietic Stem Cells , Humans , Male , Retrospective Studies , Transplantation Conditioning
6.
Journal of Experimental Hematology ; (6): 1246-1252, 2019.
Article in Chinese | WPRIM | ID: wpr-775733

ABSTRACT

OBJECTIVE@#To analyze the clinical outcomes of engraftment, graft-versus-host disease (GVHD) and survival in the patients with AML1-ETO positive acute myeloid leukemia (AML) treated with unrelated umbilical cord blood transplantation (UCBT).@*METHODS@#Forty-Five patients with high-risk refractory AML1-ETO positive AML were treated with a single UCBT in a single center from July 2010 to April 2018. All the patients underwent a myeloablative preconditioning regimen,and cyclosporine A (CSA) combined with mycophenolate mofetil (MMF) was used to prevent GVHD.@*RESULTS@#The median value of total nucleated cells (TNC) in cord blood was 5.21 (1.96-12.68)×10/kg recipient body weight, and that of CD34+ cells was 5.61 (0.56-15.4)×10/kg recipient weight. The implantation rate of neutrophil at 42 d and that of platelet at 120 d were 95.6% and 86.7%, respectively. The median time of absolute neutrophil count (ANC)>0.5×10/L and platelet 20×10/L were 16 (12-18) d and 37 (17-140) d after transplantation, respectively. The cumulative incidence of Ⅰ -Ⅳ grade acute GVHD (aGVHD) at 100 d after transplantation was 48.9% (95% CI 33.5%-62.6%), Ⅱ-Ⅳ grade aGVHD occurred in 12 cases (33.3%) (95% CI 20%-47.2%) , and Ⅲ-Ⅳ grade a GVHD in 8 cases (20%) (95% CI 9.8% -32.8%). In 5 cases of 40 patients survived over 100 days, the chronic GVHD (cGVHD) occurred after transplantation, among which 4 were localized, and 1 was extensive. 3 patients relapsed, and the 2-year cumulative relapse rate was 9.5% (95% CI 2.4%-22.8%). The median follow-up time was 23.5 (0.9-89.67) months, 10 patients died, 2-year disease-free survival rate (DFS) was 72.7%, and overall survival rate (OS) was 75.5%. Multivariate analysis showed that Ⅲ-Ⅳ. acute GVHD (aGVHD) affected overall survival.@*CONCLUSION@#UCBT is an effective rescue treatment for patients with high-risk refractory AML1-ETO positive AML.


Subject(s)
Cord Blood Stem Cell Transplantation , Core Binding Factor Alpha 2 Subunit , Graft vs Host Disease , Humans , Leukemia, Myeloid, Acute , Mycophenolic Acid , Oncogene Proteins, Fusion , Peripheral Blood Stem Cell Transplantation , RUNX1 Translocation Partner 1 Protein , Transplantation Conditioning
7.
Journal of Experimental Hematology ; (6): 1633-1640, 2019.
Article in Chinese | WPRIM | ID: wpr-775672

ABSTRACT

OBJECTIVE@#To investigate the effects of cytomegalovirus (CMV) DNA load on immune reconstitution and clinical outcomes of patients after unrelated cord blood transplantation (UCBT).@*METHODS@#Eight-color flow cytometry was used to dynamically monitor the changes of peripheral blood lymphocyte subsets of 41 patients at one year after UCBT, and 10 healthy volunteers were enroled as controls. Patients were divided into two groups according to the DNA load of CMV (DNA copies <1000/ml and DNA copies ≥1000/ml). Comparative analyse of the effect of CMV DNA load on lymphocyte subsets and transplantation outcomes were carried out after transplantation.@*RESULTS@#The high CMV DNA load group showed a faster and expanded T cell reconstitution, and the differences between the two groups were statistically significant at one and nine months after transplantation (0.38×10 /L vs 0.25×10 /L, P=0.015 and 2.53×10 /L vs 1.36×10 /L, P=0.006, respectively). Further analysis of T cell subsets suggested that CD8 T cells presented a higher and faster recovery in the high DNA load group, and the differences between the two groups were statistically significant at one and nine months after transplantation (0.20×10 /L vs 0.10×10 /L, P=0.038 and 1.62×10 /L vs 0.68×10 /L, P=0.003, respectively). In addition, there were no significant differences in levels of B cells, regulatory B cells and NK cells between the two groups. Outcomes after one- and a-half-year transplantation showed that there were no significant difference in relapse, non-relapse mortality and overall survival between the high and the low DNA load groups (7.7% vs 7.5%) (P=0.900) (15.4% vs 21.4%) (P=0.686) and (76.9% vs 78.6%) (P=0.889) respectively.@*CONCLUSION@#The high CMV DNA load induces a faster and long-lasting expansion of T cells, mainly as the expansion of CD8 T cells after UCBT. Besides, under the current pre-emptive treatment of CMV, the high CMV DNA load does not affect the early survival of patients with acute myeloid leukemia after UCBT.


Subject(s)
CD8-Positive T-Lymphocytes , Cord Blood Stem Cell Transplantation , Cytomegalovirus , DNA , Hematopoietic Stem Cell Transplantation , Humans , Immune Reconstitution
8.
Article in English | WPRIM | ID: wpr-785307

ABSTRACT

The dose of CD34+ cells is known to influence the outcome of allogeneic peripheral blood stem cell (PBSC) and/or T-cell-depleted transplantation. A previous study proposed that 2×10⁶ CD34+ cells/kg is the ideal minimum dose for allogeneic transplantation, although lower doses did not preclude successful therapy. In the case we present here, CD34+ cells were collected from a matched sibling donor on the day of allogeneic hematopoietic stem cell transplantation; however, the number of cells was not sufficient for transplantation. Consequently, PBSCs were collected three additional times and were infused along with cord blood cells from the donor that were cryopreserved at birth. The cumulative dose of total nuclear cells and CD34+ cells was 15.9×10⁸ cells/kg and 0.95×10⁶ cells/kg, respectively. White blood cells from this patient were engrafted on day 12. In summary, we report successful engraftment after infusion of multiple low doses of CD34+ cells in a patient with severe aplastic anemia.


Subject(s)
Anemia, Aplastic , Cord Blood Stem Cell Transplantation , Fetal Blood , Hematopoietic Stem Cell Transplantation , Humans , Leukocytes , Parturition , Peripheral Blood Stem Cell Transplantation , Siblings , Stem Cells , Tissue Donors , Transplantation, Homologous
9.
Journal of Experimental Hematology ; (6): 1816-1821, 2018.
Article in Chinese | WPRIM | ID: wpr-774380

ABSTRACT

OBJECTIVE@#To explore the clinical efficacy and safety of unrelated umbilical cord blood transplantation (UCBT) for the treatment of Wiskott-Aldrich syndrome(WAS).@*METHODS@#Five pediatric patients with WAS received single UCBT were retrospectively analyzed. The median age of these male patients was 268 days (range, 3 days -695 days). Among them, 2 patients were transplanted with a 6/6 matched cord blood graft,the other 3 patients received a 5/6 matched cord blood graft. Myeloablative conditioning regimen was applied, and all patients received a combination of cyclosporine and mycophenolate mofetil for the prophylaxis of graft versus host disease (GVHD). The recovery time of neutrophils and platelets as well as chimerism after transplantation were taken as the evidence of hematopoietic reconstruction.@*RESULTS@#All the five pediatric patients had hematopoietic recovery. A median time of neutrophil cells after transplantation was at 15.8 days (range,11 days -25 days), and platelet recovery was at a median of 20.4 days(range,12 days-30 days). Chimerism data were available for 5 patients at 30 days after UCBT, 4 out of the 5 patients had full donor chimerism and only one patient had mixed chimerism. There were 2 cases with pre-engraftment syndrome, 3 cases with acute GVHD gradeⅠ-Ⅲ, 4 cases with pulmonary infection and cytomegalovirus infection, but chronic GVHD was not observed in 5 cases. Four patients were alive with a median follow-up of 12.3 months (range, 5 months-17 months), and one patient had died at 22 days after UCBT.@*CONCLUSION@#Unrelated umbilical cord blood transplantation is a safe and effective treatment method for Wiskott-Aldrich syndrome.


Subject(s)
Cord Blood Stem Cell Transplantation , Graft vs Host Disease , Humans , Infant , Infant, Newborn , Male , Retrospective Studies , Transplantation Conditioning , Treatment Outcome , Wiskott-Aldrich Syndrome
10.
Rev. cuba. hematol. inmunol. hemoter ; 33(1): 1-19, ene.-mar. 2017. ilus, tab
Article in Spanish | LILACS | ID: biblio-901072

ABSTRACT

Durante los últimos 50 años, el trasplante alogénico de células progenitoras hematopoyéticas (CPH) se convirtió en un tratamiento cada vez más utilizado en la curación de hemopatías malignas y enfermedades no malignas y genéticas, como la drepanocitosis y algunas inmunodeficiencias primarias. Sin embargo, la ausencia de donantes adecuados, por no contar los pacientes con hermanos u otros familiares histocompatibles, ha motivado la búsqueda de fuentes alternativas en donantes no relacionados para garantizar la eficacia y seguridad del trasplante. Una fuente alternativa muy utilizada es la sangre de cordón umbilical (SCU); que ahora se convierte también en una fuente de células para la medicina regenerativa. Los programas de colecta y criopreservación en bancos de SCU (BSCU) se han convertido en una realidad en muchos países dada la importancia de estos tratamientos y debido a sus múltiples ventajas. Sin embargo, estas instalaciones están sujetas a regulaciones nacionales e internacionales, amparadas en estándares y procesos de acreditación. Contar con un programa de colecta y un BSCU público en Cuba es una necesidad para el desarrollo del Sistema Nacional de Salud que resolverá los problemas actuales de carencia de donantes y el intercambio internacional en la lucha por una salud pública mejor(AU)


During the last 50 years, stem cell (SC) allogenic transplant has been an everyday most used form of treatment for the cure of malignant hemopathies and other non-malignant diseases and genetic disorders, such as sickle cell disease and some primary immunodeficiency. Nevertheless, the lack of adequate donors caused by patients without histocompatible brothers or relatives has made it necessary to look for alternatives in non-related donors to guarantee the efficacy and security of transplants. A commonly used source is cord blood (CB); nowadays also known as a source of SC for regenerative medicine. Collection and cryopreservation in CB banks (CBB) have become a reality in many countries due to the importance of these treatments, and to their multiple advantages. Nevertheless, these facilities are subject to national and international regulations, guided by standards and accreditation process. Having a public CBB in Cuba is a need for the development of our National Health System which will allow us to solve the actual donor problem and will allow the international exchange in the struggle for a better public health care(AU)


Subject(s)
Humans , Male , Female , Cord Blood Stem Cell Transplantation/methods , Blood Banks/statistics & numerical data , Blood Preservation/methods , Cryopreservation/methods , Cuba
11.
Article in English | WPRIM | ID: wpr-728584

ABSTRACT

In this study, we aim to determine the in vivo effect of human umbilical cord blood-derived multipotent stem cells (hUCB-MSCs) on neuropathic pain, using three, principal peripheral neuropathic pain models. Four weeks after hUCB-MSC transplantation, we observed significant antinociceptive effect in hUCB-MSC–transplanted rats compared to that in the vehicle-treated control. Spinal cord cells positive for c-fos, CGRP, p-ERK, p-p 38, MMP-9 and MMP 2 were significantly decreased in only CCI model of hUCB-MSCs-grafted rats, while spinal cord cells positive for CGRP, p-ERK and MMP-2 significantly decreased in SNL model of hUCB-MSCs-grafted rats and spinal cord cells positive for CGRP and MMP-2 significantly decreased in SNI model of hUCB-MSCs-grafted rats, compared to the control 4 weeks or 8weeks after transplantation (p<0.05). However, cells positive for TIMP-2, an endogenous tissue inhibitor of MMP-2, were significantly increased in SNL and SNI models of hUCB-MSCs-grafted rats. Taken together, subcutaneous injection of hUCB-MSCs may have an antinociceptive effect via modulation of pain signaling during pain signal processing within the nervous system, especially for CCI model. Thus, subcutaneous administration of hUCB-MSCs might be beneficial for improving those patients suffering from neuropathic pain by decreasing neuropathic pain activation factors, while increasing neuropathic pain inhibition factor.


Subject(s)
Animals , Cord Blood Stem Cell Transplantation , Humans , Injections, Subcutaneous , Multipotent Stem Cells , Nervous System , Neuralgia , Rats , Spinal Cord , Tissue Inhibitor of Metalloproteinase-2 , Umbilical Cord
12.
Article in Chinese | WPRIM | ID: wpr-351334

ABSTRACT

<p><b>OBJECTIVE</b>To analyze the clinical features of 6 children with Duchenne muscular dystrophy (DMD) and review related literature, and to provide a basis for early diagnosis and effective treatment of this disease.</p><p><b>METHODS</b>A retrospective analysis was performed on the clinical data of 6 children with DMD who were admitted to the First Affiliated Hospital of Nanjing Medical University from January 2010 to October 2015.</p><p><b>RESULTS</b>All the 6 cases were boys without a family history of DMD, and the age of diagnosis of DMD was 1.2-11.5 years. All patients had insidious onset and increases in alanine aminotransferase, aspartate aminotransferase, lactate dehydrogenase, α-hydroxybutyrate dehydrogenase, creatine kinase (CK), and creatine kinase-MB, particularly CK, which was 3.3-107.2 times the normal level. Their gene detection results all showed DMD gene mutation. The gene detection results of two children's mothers showed that they carried the same mutant gene. The muscle biopsy in one case showed that the pathological changes confirmed the diagnosis of DMD. The level of CK in one case declined by 77.0% 5 days after umbilical cord blood mesenchymal stem cell transplantation.</p><p><b>CONCLUSIONS</b>For boys with abnormal serum enzyme levels and motor function, DMD should be highly suspected. It should be confirmed by CK and DMD gene detection as soon as possible. And the progression of the disease could be delayed by early intervention for protecting the remaining normal muscle fibers.</p>


Subject(s)
Child , Child, Preschool , Cord Blood Stem Cell Transplantation , Creatine Kinase , Genetics , Dystrophin , Genetics , Humans , Infant , Male , Muscular Dystrophy, Duchenne , Genetics , Therapeutics , Retrospective Studies
13.
Article in Chinese | WPRIM | ID: wpr-300449

ABSTRACT

<p><b>OBJECTIVE</b>To investigate the clinical features of readmitted children with bronchopulmonary dysplasia (BPD) in the first 2 years of life.</p><p><b>METHODS</b>A retrospective analysis was performed for the clinical data of 242 children with BPD who were readmitted due to recurrent lower respiratory tract infection (LRTI) in the first 2 years of life.</p><p><b>RESULTS</b>Among all the 242 children with BPD, 115(47.5%) had wheezing, and the children aged 1-2 years had a significantly higher incidence rate of wheezing than those aged less than 1 year (P<0.05). Chest imaging was performed for 193 children, among whom 31 (16.1%) had hyperlucent areas. Pulmonary function examination showed that the BPD children had significantly lower TV/kg, TPEF/TE, VPEF/VE, TEF50 and TEF75, and significantly higher respiratory rate than the controls without respiratory disease (P<0.05). Bronchoscopy was performed for 28 children, among whom 21 (75%) had airway dysplasia. All the 242 children used inhaled corticosteroids (ICS) and experienced no treatment-related adverse reactions. Six children were given intravenous infusion of human umbilical cord blood mesenchymal stem cells (hUCB-MSCs) and experienced no infusion-related events or adverse reactions, among whom one child successfully stopped oxygen therapy.</p><p><b>CONCLUSIONS</b>The incidence rate of wheezing increases with the increase in age in children with BPD who are readmitted due to LRTI. Pulmonary function examination shows small airway obstruction, reduced expiratory flow rate in case of low lung capacity, and increased respiratory rate, and most children have airway dysplasia. ICS can be used to inhibit inflammatory response in the acute stage. Infusion of hUCB-MSCs is safe and feasible and may bring some benefits to the recovery from BPD.</p>


Subject(s)
Bronchopulmonary Dysplasia , Therapeutics , Cord Blood Stem Cell Transplantation , Female , Humans , Infant , Infant, Newborn , Lung , Male , Patient Readmission , Respiratory Sounds , Retrospective Studies
14.
In. Decaro, Jorge; Lemos, José Felipe. Medicina transfusional en el trasplante de células progenitoras hematopoyéticas. Montevideo, s.n, 2017. p.321-348, tab.
Monography in Spanish | LILACS, BNUY, UY-BNMED | ID: biblio-1290490
15.
Rev. Assoc. Med. Bras. (1992) ; 62(supl.1): 16-22, Oct. 2016. tab
Article in English | LILACS | ID: biblio-829566

ABSTRACT

SUMMARY Sickle-cell diseases are the most common inherited hemoglobinopathies worldwide. Improvement in survival has been seen in the last decades with the introduction of careful screening and prevention of complications and the introduction of hydroxyurea. Stem-cell transplantation is currently the only curative option for these patients and has been indicated for patients with neurological events, repeated vaso-occlusive crisis, any organ damage or presence of red blood cell antibodies. Related bone-marrow or cord-blood transplant has shown an overall survival of more than 90% with a disease-free survival of 90% in 1,000 patients transplanted in the last decades. The use of unrelated donors unfortunately has not shown the same good results, but better typing methods and improved support may improve the outcome with this source of stem cells in the future. In Brazil, only recently stem cell transplant from related donors has been included in the procedures performed in the public health system. The use of related bone marrow or cord blood and a myeloablative conditioning regimen are considered standard of care for patients with sickle-cell diseases. Transplants with non-myeloablative regimens, unrelated donors or haploidentical donors should be performed only in controlled clinical trials.


RESUMO As doenças falciformes são as hemoglobinopatias mais frequentes mundialmente. Nas últimas décadas vivenciamos melhora na sobrevida de portadores destas patologias com a introdução de medidas preventivas e o uso precoce da hidroxiurea. O transplante de medula óssea alogênico (alo TMO) é a única opção terapêutica curativa para as hemoglobinopatias. O mesmo tem sido indicado para pacientes com complicações neurológicas, crises vasoclusivas repetidas, alguma lesão orgânica e alosensibilizados. O uso de doadores relacionados de medula óssea ou cordão umbilical mostrou em 1000 procedimentos realizados sobrevida global de 95% e sobrevida livre de ventos de 90%. O uso de doadores não aparentados não mostrou resultados tão expressivos, mas no futuro métodos melhores de tipagem de HLA e de medidas de suporte podem melhorar estes resultados. No Brasil apenas recentemente o alo TMO foi incluído no âmbito do sistema único de saúde (SUS) como opção terapêutica para portadores de doenças falciformes. O uso de doadores aparentados de MO ou de SCU com regime mieloablativo é considerado hoje tratamento estabelecido, sendo que o uso de doadores alternativos não aparentados ou haploidenticos e o uso de transplante com regime não mieloablativo deve ser considerado apenas em estudos clínicos.


Subject(s)
Humans , Bone Marrow Transplantation/methods , Anemia, Sickle Cell/surgery , Transplantation, Homologous , Severity of Illness Index , Brazil , Hematopoietic Stem Cell Transplantation/methods , Disease-Free Survival , Transplantation Conditioning/methods , Myeloablative Agonists/therapeutic use , Cord Blood Stem Cell Transplantation/methods , National Health Programs
16.
Article in English | WPRIM | ID: wpr-110760

ABSTRACT

We induced percutaneous spinal cord injuries (SCI) using a balloon catheter in 45 rats and transplanted human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) at the injury site. Locomotor function was significantly improved in hUCB-MSCs transplanted groups. Quantitative ELISA of extract from entire injured spinal cord showed increased expression of brain-derived neurotrophic factor (BDNF), nerve growth factor (NGF) and neurotrophin-3 (NT-3). Our results show that treatment of SCI with hUCB-MSCs can improve locomotor functions, and suggest that increased levels of BDNF, NGF and NT-3 in the injured spinal cord were the main therapeutic effect.


Subject(s)
Animals , Brain-Derived Neurotrophic Factor/genetics , Cord Blood Stem Cell Transplantation , Enzyme-Linked Immunosorbent Assay , Gene Expression Profiling , Gene Expression Regulation , Humans , Locomotion , Nerve Growth Factor/genetics , Rats , Spinal Cord Injuries/therapy
17.
Article in Chinese | WPRIM | ID: wpr-340604

ABSTRACT

<p><b>OBJECTIVE</b>To explore the effects of umbilical cord blood mononuclear cells (UCBMC) transplantation on the neuronal apoptosis and the expression of Bcl-2 and Bax proteins in neonatal rats with hypoxic-ischemic brain damage (HIBD).</p><p><b>METHODS</b>Seven-day-old Sprague-Dawley neonatal rats were randomly divided into normal control (N)+normal saline (NS), HIBD+NS, N+UCBMC, and HIBD+UCBMC groups. HIBD model was prepared using the classical Rice-Vannucci method. Twenty-four hours after HIBD, UCBMC were transplanted in the N+UCBMC and HIBD+UCBMC groups. Seven days after transplantation, NeuN/Cleaved-Caspase-3 double immunofluorescence staining and TUNEL methods were used to observe neural apoptosis in the cortex. The expression levels of Bax and Bcl-2 proteins were examined by Western blot analysis.</p><p><b>RESULTS</b>There were more NeuNcleaved Caspase-3DAPIand TUNELDAPIcells in the HIBD+NS group compared with the N+NS and N+UCBMC groups (P<0.01). There were less NeuNcleaved Caspase-3DAPIand TUNELDAPIcells in the HIBD+UCBMC group compared with the HIBD+NS group (P<0.01). The concentration of Bax protein was higher and that of Bcl-2 proteins was lower in the HIBD+NS group compared with the N+NS and N+UCBMC groups (P<0.01). The concentration of Bax protein in HIBD+UCBMC group was lower than that in the HIBD+NS group (P<0.01). The concentration of Bcl-2 protein was higher compared with the HIBD+NS, N+NS and N+UCBMC groups (P<0.05).</p><p><b>CONCLUSIONS</b>UCBMC transplantation via lateral ventricle can upregulate the expression of Bcl-2 protein and down-regulate the expression of Bax protein, thus alleviating brain neural apoptosis in neonatal rats with HIBD.</p>


Subject(s)
Animals , Animals, Newborn , Apoptosis , Caspase 3 , Metabolism , Cord Blood Stem Cell Transplantation , Methods , Female , Hypoxia-Ischemia, Brain , Metabolism , Pathology , Therapeutics , Male , Neurons , Pathology , Proto-Oncogene Proteins c-bcl-2 , Rats , Rats, Sprague-Dawley , bcl-2-Associated X Protein
18.
Braz. j. infect. dis ; 19(6): 571-577, Nov.-Dec. 2015. tab, graf
Article in English | LILACS | ID: lil-769634

ABSTRACT

ABSTRACT Disposal of Umbilical Cord Blood Units due to microbial contamination is a major problem in Cord Blood Banks worldwide as it reduces the number of units available for transplantation. Additionally, economic losses are generated as result of resources and infrastructure used to obtain such units. Umbilical Cord Blood Units that showed initial microbial contamination were subject to strains isolation, identification, and characterization by sequencing the 16S rRNA gene and Enterobacterial Repetitive Intergenic Consensus (ERIC-PCR). Moreover, tests of antimicrobial resistance/sensitivity and phenotypic activities that may play an important role in microbial infection were performed. Microbial contamination was detected in 120 Umbilical Cord Blood Units (2.31%) in the period from 2003 to 2013. The most frequently isolated strains were Enterococcus faecium, followed by Staphylococcus epidermidis, Escherichia coli, Enterococcus faecalis, Staphylococcus haemoliticus, Klebsiella pneumoniae, Enterococcus durans, Lactobacillus helveticus, Enterococcus hiriae and Roseomonas genomospecies 5. The ERIC-PCR assays revealed a wide genetic diversity in some strains although belonging to the same genus and specie, indicating different sources of contamination. Broad-spectrum penicillins, third generation cephalosporins, aminoglycosides, and fluoroquinolones showed lower inhibitory activity on the tested strains. All strains were proteolytic, 67.69% were amylase-positive, 27.6% hemolysis-positive, and 34.71% nuclease-positive. The most common sources of contamination were: vaginal flora, digestive tract, and skin flora, highlighting the need for staff training in good manufacturing practices in collection SCU since all contaminants identified are part of the microbial flora of the donors. Implications and consequences in the therapeutic use of Umbilical Cord Blood Units for transplantation contaminated by multiresistant bacteria in immunocompromised patients are discussed.


Subject(s)
Humans , Blood Preservation , Cord Blood Stem Cell Transplantation , Fetal Blood/microbiology , Gram-Negative Bacteria/isolation & purification , Gram-Positive Bacteria/isolation & purification , Anti-Bacterial Agents/pharmacology , Blood Banks , Genetic Markers , Genotype , Gram-Negative Bacteria/classification , Gram-Negative Bacteria/drug effects , Gram-Positive Bacteria/classification , Gram-Positive Bacteria/drug effects , Microbial Sensitivity Tests , Molecular Typing , Phylogeny , Retrospective Studies
19.
Braz. j. med. biol. res ; 48(10): 871-876, Oct. 2015. tab, ilus
Article in English | LILACS | ID: lil-761603

ABSTRACT

Treatments for patients with hematologic malignancies not in remission are limited, but a few clinical studies have investigated the effects of salvaged unrelated cord blood transplantation (CBT). We retrospectively studied 19 patients with acute leukemia, 5 with myelodysplastic syndrome (MDS with refractory anemia with excess blasts [RAEB]), and 2 with non-Hodgkin's lymphoma who received 1 CBT unit ≤2 loci human leukocyte antigen (HLA)-mismatched after undergoing myeloablative conditioning regimens between July 2005 and July 2014. All of them were in non-remission before transplantation. The infused total nucleated cell (TNC) dose was 4.07 (range 2.76-6.02)×107/kg and that of CD34+ stem cells was 2.08 (range 0.99-8.65)×105/kg. All patients were engrafted with neutrophils that exceeded 0.5×109/L on median day +17 (range 14-37 days) and had platelet counts of >20×109/L on median day +35 (range 17-70 days). Sixteen patients (61.5%) experienced pre-engraftment syndrome (PES), and six (23.1%) patients progressed to acute graft-versus-host disease (GVHD). The cumulative incidence rates of II-IV acute GVHD and chronic GVHD were 50% and 26.9%, respectively. After a median follow-up of 27 months (range 5-74), 14 patients survived and 3 relapsed. The estimated 2-year overall survival (OS), disease-free survival (DFS), and non-relapse mortality (NRM) rates were 50.5%, 40.3%, and 35.2%, respectively. Salvaged CBT might be a promising modality for treating hematologic malignancies, even in patients with a high leukemia burden.


Subject(s)
Adolescent , Adult , Child , Female , Humans , Male , Young Adult , Allografts , Anemia, Refractory, with Excess of Blasts/therapy , Cord Blood Stem Cell Transplantation , Graft vs Host Disease , Leukemia, Biphenotypic, Acute/therapy , Lymphoma, Non-Hodgkin/therapy , Anemia, Refractory, with Excess of Blasts/mortality , Cord Blood Stem Cell Transplantation/mortality , Disease-Free Survival , Follow-Up Studies , Graft vs Host Disease/mortality , Hematologic Neoplasms/mortality , Hematologic Neoplasms/therapy , Leukemia, Biphenotypic, Acute/mortality , Leukemia, Lymphoid/mortality , Leukemia, Lymphoid/therapy , Leukemia, Myeloid/mortality , Leukemia, Myeloid/therapy , Leukemia/mortality , Leukemia/therapy , Lymphoma, Non-Hodgkin/mortality , Myelodysplastic Syndromes/mortality , Myelodysplastic Syndromes/therapy , Retrospective Studies , Remission Induction/methods , Treatment Outcome
20.
Rev. bras. hematol. hemoter ; 37(4): 236-241, July-Aug. 2015. tab, ilus
Article in English | LILACS | ID: lil-756561

ABSTRACT

Hematopoietic stem cell transplantation has been successfully used to treat the pediatric population with malignant and non-malignant hematological diseases. This paper reports the results up to 180 days after the procedure of all unrelated hematopoietic stem cell transplantations in pediatric patients that were performed in one institution.METHODS: A retrospective review was performed of all under 18-year-old patients who received unrelated transplantations between 1995 and 2009. Data were analyzed using the log-rank test, Cox stepwise model, Kaplan-Meier method, Fine and Gray model and Fisher's exact test.RESULTS: This study included 118 patients (46.8%) who received bone marrow and 134 (53.2%) who received umbilical cord blood transplants. Engraftment occurred in 89.47% of the patients that received bone marrow and 65.83% of those that received umbilical cord blood (p-value < 0.001). Both neutrophil and platelet engraftments were faster in the bone marrow group. Acute graft-versus-host disease occurred in 48.6% of the patients without statistically significant differences between the two groups (p-value = 0.653). Chronic graft-versus-host disease occurred in 9.2% of the patients with a higher incidence in the bone marrow group (p-value = 0.007). Relapse occurred in 24% of the 96 patients with malignant disease with 2-year cumulative incidences of 45% in the bone marrow group and 25% in the umbilical cord blood group (p-value = 0.117). Five-year overall survival was 47%, with an average survival time of 1207 days, and no significant differences between the groups (p-value = 0.4666).CONCLUSION: Despite delayed engraftment in the umbilical cord blood group, graft-versus-host disease, relapse and survival were similar in both groups...


Subject(s)
Humans , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Child , Cord Blood Stem Cell Transplantation , Hematologic Diseases , Hematopoietic Stem Cell Transplantation , Stem Cell Transplantation , Unrelated Donors
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