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Odinak et al. (Abstract)

Cellular Therapy and Transplantation (CTT), Vol. 3, No. 9
doi: 10.3205/ctt-2010-No9-abstract52
© The Authors. This abstract is provided under the following license: Creative Commons Attribution 3.0 Unported

Abstract accepted for "4th Raisa Gorbacheva Memorial Meeting on Hematopoietic Stem Cell Transplantation",
Saint Petersburg, Russia, September 18–20, 2010

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Mesenchymal stem cell transplantation as a new treatment strategy in patents with multiple sclerosis and amyotrophic lateral sclerosis: a five year experience

Miroslav M. Odinak1, Gennadiy N. Bisaga1, Andrey V. Novitsky2, Vadim V. Tyrenko2, Dmitriy G. Polyntsev3, Petr V. Krugliakov3, Alexander B. Smolyaninov4

1Department of Neurology Military Medical Academy, St. Petersburg, Russia; 2Department of bone marrow transplantation Military Medical Academy, St. Petersburg, Russia; 3Trans–technologies Ltd., St. Petersburg, Russia; 4Pokrovskiy stem cell bank, St. Petersburg, Russia

Correspondence: Andrey V. Novitsky, Dept. of Bone marrow transplantation of the Medical Military Academy, Lebedev str 6 A, 194044, St. Petersburg, Russia, E-mail: anov1@spam is badmail.ru

Abstract

Background: The most significant degenerative and progressive diseases are amyotrophic lateral sclerosis (ALS) and multiple sclerosis (MS). Stem cell transplantation has been proposed as the most promising therapeutic strategy for this category of patients. Human mesenchymal stem cells (MSCs) are multipotent cells that have the potential to differentiate into lineages of mesenchymal tissues including bone, muscle, neurons, and oligodendrocytes.

Materials and methods: From 2005 to 2010 autologous MSCs were isolated from the bone marrow of 8 patients with MS (3F, 5M, aged 25–39 yrs, duration 3–14 ys, EDSS 3.0–7.0) and 12 patients with ALS (5F, 7M, aged 38–63 yrs, duration 15–57 months, 32–20 points on the ALSSS scale) Growth kinetics, immunophenotypes, and karyotypes were evaluated during in vitro expansion. The in vitro expanded MSCs did not show any bacterial or fungal contamination, hemopoietic cell presence, chromosomal alterations, or early cellular senescence. The patients received monthly intravenous injections of autologous MSCs in doses of 2 x 106 cells/kg for 3–20 months. No signs of abnormal cell proliferation were observed.

Results: No significant acute or late side effects were in evidence. Minor adverse events were headaches and transient hyperthermia after the MSC infusion. Four ALS patients died 3–6 mths after the start of therapy due to conditions not directly related to the MSC therapy itself: 1 pt committed suicide (had not had any positive results from therapy), 2 pts died of cardiac arrest (both had a long history of ischemic cardiac disease), and 1 pt died of disease progression and refusal of mechanical ventilation. Three ALS patients show a significant (for 4–10 mo), 3 a doubtful (for 1–3 mo), and 5 a lack of slowing of progression. The EDSS scores of 7 MS patients show a stabilization and decrease in 0.5 to 1 point despite repeated relapses every 3 mo in 1 pt, and one patient experienced disease progression.

Conclusion: A five-year experience of the stem cell therapy in MS and ALS demonstrates that MSC therapy is safe and represents a good chance for MS patients, but is considerably less preferable in ALS patients and may be used as a palliative treatment.

Keywords: stem cell, cell therapy, multiple sclerosis, lateral sclerosis, transplantation, mesenchymal stem cells

 

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