Author/Authors :
Zakerinia, M. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Kamgarpour, A. Department of Neurosurgery- Shiraz University of Medical Sciences, Shiraz , Nemati, H. Department of Pediatrics- Shiraz University of Medical Sciences, Shiraz , Zare, H. R. Department of Immunology- Medical School- Shiraz University of Medical Sciences, Shiraz , Ghasemfar, M. Department of Anesthesiology- Shiraz University of Medical Sciences, Shiraz , Rezvani, A. R. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Karimi, M. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Nourani Khojasteh, H. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Dehghani, M. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Vojdani, R. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Haghighat, S. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Namdari, N. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Rekabpoor, J. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz , Amirghofran, S. The International Branch- Shiraz University of Medical Sciences, Shiraz , Amirghofran, Z. Department of Immunology- Medical School- Shiraz University of Medical Sciences, Shiraz , Yosefipour, G. A. Department of Neurology- Shiraz University of Medical Sciences, Shiraz , Ramzi, M. Bone Marrow Transplant Unit- Department of Internal Medicine- Shiraz University of Medical Sciences, Shiraz
Abstract :
Background: Cellular transplantation is a promising treatment strategy for neurological diseases.
Objective: To report the results of intrathecal hematopoietic stem cell therapy in different neurological
diseases in the past 6 years in a single center.
Methods: From October 2011 to September 2018, 220 patients with various neurological diseases were
transplanted intrathecally by their bone marrow stem cells. To have a longer follow up, we only reported
the first 80 patients, transplanted up to July 2015—10 patients had spinal cord injuries and paralysis, 12
had advanced Parkinson’s disease, 28 had cerebral palsy, 7 had hypoxic brain damage, 2 had autism, 4
had multiple sclerosis, 5 had progressive cerebellar atrophy, and 12 had other neurological diseases. The
patients were admitted to the Bone Marrow Transplant Unit. On the first day, 50–200 (median 100) mL
bone marrow was aspirated from the patients’ posterior iliac crests, mixed with 120 mL culture media
(RPMI), and 12 mL heparin. The samples were then transferred to immunology lab in cold box. Mononuclear
cells (MNCs) were separated by a Ficoll-Hypaque gradient, washed, and suspended in ringers.
Cell viability was assessed with trypan blue viability test. Transplantation was performed 3–4 hours after
bone marrow collection. 5–10 mL of the cerebrospinal fluids were aspirated and about 20 mL MNCs
(containing stem cells) in ringers were injected intrathecally (IT). The patients were laid down on their
back for 4–5 hours. The median number of MNCs was 4×107 (range 1–450×107). The median viability of
the cells was 90% (range 60%–98%). The patients received intravenous ceftriaxone every 12 hours and
were discharged from the hospital few days after autologous stem cell therapy.
Results: We noted clinical improvements in 9 of 12 patients with Parkinson’s disease, 20 of 28 patients
with cerebral palsy, 6 of 7 patients with hypoxic brain damage, 2 of 4 patients with multiple sclerosis, and 4 of 5 patients with cerebellar atrophy. The improvements were noted after 2–4 weeks of cell therapy.
There were no improvements in patients with spinal cord injury and complete paralysis and those with
autism. There were variable improvements in other patients treated.
Conclusion: Most patients with advanced Parkinson’s disease, cerebral palsy, hypoxic brain damage, progressive
cerebellar atrophy, and kernicterus neuropathy reported clinical effects of this safe intervention
resulting in better functioning and an increased quality of life.
