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Neurosurgery. 2011 Mar;68(3):588-600. doi: 10.1227/NEU.0b013e318207734c.3 `3 e* X7 c! w5 Q
Autologous bone marrow mononuclear cell therapy for severe traumatic brain injury in children.
# m5 l9 [: _# [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.: I" }7 P5 r+ w6 I
Author information: Q$ q4 i% j6 F+ v- u. ?
' c9 z5 e/ \. O2 u8 V/ EAbstract3 t8 n/ n" n: H, B
BACKGROUND:9 b! A6 x) u/ @
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.) r) k9 Q h# _/ w2 R' O
OBJECTIVE:3 |1 ]# n* d) D5 L0 S
To determine whether autologous BMMNCs are a safe treatment for severe TBI in children.
2 J- i: |" W$ q- Z8 l m' O; w3 wMETHODS:
* \' j1 J. v8 f/ r# E1 i. a( TTen 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.6 t/ D) Y& W2 d
RESULTS:' Q5 k W" l3 g+ P( f, O- }
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. |
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发表于 2014-1-4 10:03
