|
 
- 积分
- 414
- 威望
- 414
- 包包
- 645
|
Neurosurgery. 2011 Mar;68(3):588-600. doi: 10.1227/NEU.0b013e318207734c.8 h ?, L! t9 q, \' W: Y" A
Autologous bone marrow mononuclear cell therapy for severe traumatic brain injury in children.7 t6 Y$ l' K. n8 z$ x, H
Cox CS Jr, Baumgartner JE, Harting MT, Worth LL, Walker PA, Shah SK, Ewing-Cobbs L, Hasan KM, Day MC, Lee D, Jimenez F, Gee A.
4 e; l7 D# q0 r r" _$ HAuthor information0 z ?! G2 Q# h
1 Z" c, _( p8 S( }, o- dAbstract$ S( u. y5 s t6 G
BACKGROUND:
" R( V) h' V% W/ @ T1 ^4 ^Severe traumatic brain injury (TBI) in children is associated with substantial long-term morbidity and mortality. Currently, there are no successful neuroprotective/neuroreparative treatments for TBI. Numerous preclinical studies suggest that bone marrow-derived mononuclear cells (BMMNCs), their derivative cells (marrow stromal cells), or similar cells (umbilical cord blood cells) offer neuroprotection.
( P. W6 |; c( l6 \' d$ [OBJECTIVE:
4 C- k# F o) p: E2 a# J% iTo determine whether autologous BMMNCs are a safe treatment for severe TBI in children.
8 D; Z6 B, N5 Q! E* I6 C# F$ GMETHODS: j$ ^( W6 \! @# M
Ten children aged 5 to 14 years with a postresuscitation Glasgow Coma Scale of 5 to 8 were treated with 6×10 autologous BMMNCs/kg body weight delivered intravenously within 48 hours after TBI. To determine the safety of the procedure, systemic and cerebral hemodynamics were monitored during bone marrow harvest; infusion-related toxicity was determined by pediatric logistic organ dysfunction (PELOD) scores, hepatic enzymes, Murray lung injury scores, and renal function. Conventional magnetic resonance imaging (cMRI) data were obtained at 1 and 6 months postinjury, as were neuropsychological and functional outcome measures.
7 W) r+ x2 r7 q- ^RESULTS:: S" ^5 x6 x, p L5 D/ W
All patients survived. There were no episodes of harvest-related depression of systemic or cerebral hemodynamics. There was no detectable infusion-related toxicity as determined by PELOD score, hepatic enzymes, Murray lung injury scores, or renal function. cMRI imaging comparing gray matter, white matter, and CSF volumes showed no reduction from 1 to 6 months postinjury. Dichotomized Glasgow Outcome Score at 6 months showed 70% with good outcomes and 30% with moderate to severe disability. |
|
发表于 2013-12-31 11:03
发表于 2014-1-4 10:03
