Non-myeloablative Cord blood stem cell treatment for hormone resistent ulcerative colitis / 中华消化内镜杂志

ABSTRACT

Objective To study the therapeutic effects of non-myeloablative cord blood stem cell for hormone resistent ulcerative colitis ( UC )and endoscopic changes. Methods Eleven UC patients(6 males,5 females), aged 18 to 61 years old, and unresponsive to high-dose prednisolone therapy more than 3-28years, were included. Four cases were left-sided colitis, 7 were pancolitis. Ten were severe cases and 1 was moderate, others were active. Stem cells of CD34+, CD117+, CD133+ , C-kit+ and Sca-1+ were extracted from a total of 60-120 ml cord blood with the isolation kit. The total account was more than 1.0 × 108,andthe cell activity was more than 96%. The stems cells were prepared with normal saline (10 ml) to suspension, which was injected into inferior mensenteric artery via femoral catheterization. Those who received pretreatment corticosteroid resumed their previous therapy . Hormone administration gradually decreased and then ceased at the relief of symptoms. Results After 12 weeks of treatment with stem cell, the total clinical effects were completely remission in 7 cases, improvement in 3 patients, and inefficiency in one case. The clinical symptomatic remissions were complete remission in 7 cases, partial in 3, and inefficiency in 1. The colonoscopic remissions included complete remission in 6 cases, partial in 4, and inefficiency in 1. And the histologic remissions included complete remission in 6 cases, partial in 4, and inefficiency in 1. Bowel movements decreased from 11.5 times to 1.6 per day, erythrocyte sendimentation rate decreased from 44. 5mm/h to 11.5 mm/h and C reaction protein decreased from 22. 3 mg/L to 6. 1 mg/L. The Sourtherland disease active index (DAI) decreased from 11.1 to 2. 32. Hormone administration ceased in 10 cases and decreased in 1. There were no complications. The patients were followed up for 12 months, and complete remission in 5 patients, improvement in 3 others and relapse in 2 were observed. Conclusion Non-myeloablative Cord blood stem cell treatment for hormone resistent ulcerative colitis , safe and effective, is of help to relieve symptoms, heal lesions, improve histology, decrease DAI. Therefore, corticosteroid can be withdrawn.