Lymphatic drainage improvement in a case of congenital lower limb lymphedema following autologous adult stem cell transplantation

ABSTRACT

Abnormal accumulation of lymph in subcutaneous tissue is called lymphedema, which in turn, is due to lymph drainage disorder. It can be primary [congenital], or secondary [acquired]. Primary lymphedema may be present at birth, and may spread to one or more extremity, face or external genital organs. Praecox lymphedema is the most common form of primary lymphedema [94%], it commonly presents in females, [male/female 10/1]. The disorder appears in adolescence. Edema usually presents in the affected foot or leg. Conversely, the tardive form, presents after 35years of age. The early stages of the disease may partly respond to conservative therapies such as CDT [complex decongestive therapy], or limb elevation or antibiotic prophylaxis, but when the disorder progresses toward the advanced stages, the effectiveness of above treatments are minimal and temporary. To date current researches in regenerative medicine, exhibits that, stem cell therapy-induced angiogenesis, may provide new approaches for these patients. This study is an experimental study. A case of praecox lymphedema which wasn't responsive to medical conservative therapies was the candidate for autologous stem cell transplantation. Recombinant human GCSF was injected subcutaneously, [5micro g/kg body weight] to mobilize stem/progenitor cells from bone marrow to the circulation. After reaching the WBC count to about 25000 cells per ml, MNCs were separated from peripheral blood, then concentrated and injected along the lower limb lymphatic pathway. As a result, this study shows that autologous stem cell transplantation, in the case of primary lower limb lymphedema, is a new optional treatment to improve lymph drainage and subsequent alleviation of signs and symptoms and improvement in the patient's quality of life