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tianzhang

Neurosurgery. 2011 Mar;68(3):588-600. doi: 10.1227/NEU.0b013e318207734c.7 x- S3 a; E9 Q6 o% m
Autologous bone marrow mononuclear cell therapy for severe traumatic brain injury in children.
7 C4 S7 ?9 x+ w4 ?. z/ |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.
2 C) o3 A' Q/ AAuthor information
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Abstract
. g% t7 |* t7 _8 U6 t9 f9 ^5 kBACKGROUND:6 p) A: L9 g; @2 ]
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.
% J' R3 Q6 I; A: n8 E9 hOBJECTIVE:
8 L; ~) n7 r  l! R% _: d5 B8 @; NTo determine whether autologous BMMNCs are a safe treatment for severe TBI in children.
- x+ Z; O, w: x0 L; BMETHODS:5 x* R" I8 q" |$ L# K, g
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.
" c- o! D& l; n6 iRESULTS:
) j3 k0 Y# A4 b3 [8 H$ ^3 BAll 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.

tianzhang

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