Phedy Phe, Djaja Yoshi P, Gatam Luthfi, Kusnadi Yuyus, Wirawan Rosiana P, Tobing Indriati M S, Subakir Nursanti, Mappalilu Arfan, Prawira Matheus A, Yauwenas Rouna, Gatam Asrafi R
Department of Orthopaedic and Traumatology, Fatmawati Central General Hospital, Jakarta, Indonesia.
Stem Cell and Cancer Institute, PT. Kalbe Farma, Jakarta, Indonesia.
Am J Case Rep. 2019 Sep 2;20:1299-1304. doi: 10.12659/AJCR.917624.
BACKGROUND For the past 20 years, numerous of clinical trials focusing on the use of mesenchymal stem cells (MSC) in spinal cord injury (SCI) treatment has been conducted. However, controversies over whether stem cells are the main factor in a patient's recovery still persisted in sub-acute SCI. This study aimed to evaluate the motoric recovery in a chronic SCI patient treated with bone marrow derived MSC (BM-MSC) transplantation. CASE REPORT We present a case report of patient with a 12-year-long-chronic SCI that was treated by BM-MSC) transplantation using a serial administration protocol. The protocol consisted of direct parenchymal injection to the affected lesion and multiple (5 times) intravenous stem cell injection as the adjuncts. There was no complication or serious adverse effects encountered during the procedure and follow up. At the final follow up of 5 years, the patient neurological status improved from American Spinal Injury Association (ASIA) A status to ASIA C status, which signifies improvement in his ambulatory status. Magnetic resonance imaging and electrophysiology examination also showed changes that indicated recovery of the neurologic function. CONCLUSIONS Based on the limited adverse reaction and outcome, our case report may serve as an additional alternative protocol in stem cell administration to improve the outcome of chronic spinal cord injury patients.
背景 在过去20年里,已经开展了许多关于间充质干细胞(MSC)用于脊髓损伤(SCI)治疗的临床试验。然而,在亚急性脊髓损伤中,关于干细胞是否是患者恢复的主要因素仍存在争议。本研究旨在评估接受骨髓源性间充质干细胞(BM-MSC)移植治疗的慢性脊髓损伤患者的运动功能恢复情况。病例报告 我们报告一例12年慢性脊髓损伤患者,采用连续给药方案接受BM-MSC移植治疗。该方案包括直接向受影响病变部位进行实质内注射以及多次(5次)静脉注射干细胞作为辅助治疗。在手术过程和随访期间未遇到并发症或严重不良反应。在5年的最终随访中,患者的神经状态从美国脊髓损伤协会(ASIA)A等级改善为ASIA C等级,这表明其步行状态有所改善。磁共振成像和电生理检查也显示出表明神经功能恢复的变化。结论 基于有限的不良反应和结果,我们的病例报告可能作为干细胞给药的另一种方案,以改善慢性脊髓损伤患者的治疗效果。