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Autologous Stem Cell Transplantation

in Patients with chronic Spinal Cord Injury


(n=85)

Introduction

Because Autologous Stem Cells from bone marrow are easily accessible from both healthy donors and pa-
1
tients and can be expanded on a therapeutic scale, they have attracted attention for cell-based therapy .
Although the mechanisms are not yet completely understood, some small clinical trials with Spinal Cord
Injury patients have demonstrated a positive effect on their use and proved that the use of Autologous Stem
2-4
Cells is safe .

Methods

On a larger scale XCell-Center treated chronic Spinal Cord Injury Patients with Autologous Stem Cells using
the Lumbar Puncture procedure 200 ml of Bone Marrow was extracted out of the Iliaca crest and was con-
centrated for transplantation using gradient centrifugation (mean number of given cells was 6.000.000).
After treatment the patients were evaluated using a Post Treatment Survey. The results of surveys of 85 pa-
tients treated with autologous stem cell transplantation were evaluated and are presented in this poster.

Results SCI - Class of Spinal Cord Injury


Overview type of Spinal Cord Injuries (N=85)

The picture on the right shows the distribu- 1. Severity of the Spinal Cord Injury
100%

tion of the patients by severity of the Spinal Para


Complete SCI lesion Plegic
Cord Injury lesions of the treated patients. 31
42
54
Incomplete SCI lesion

50%

The side effects reported by the patients 2. Level of Spinal Cord Injury lesion
were caused by the Lumbar Puncture tre- Quadra
Plegic
High cervical lesions (c1-c4) 43
atment and not by the stem cells. The 36
20
Low cervical lesion (c5-c7)

most common side effect was a short 29 Others 0%


3. Functional Impairment

period of mild headache (15% of the pa-


tients).

Nearly 60% of the treated patients expe- SCI - Class of Spinal Cord Injury
Complete and incomplete spinal cord lesions (85)
rienced improvements. There was nearly
100%

no difference between patients classified


as an ASIA A (complete Spinal Cord Injury)
and patients classified with an ASIA B or C
(incomplete Spinal Cord Lesion). The 51 50%

figure below illustrates the kind of improve- 32


+

ments. Getting back sensation (feeling


warm or cold sensations/ touch) was re-
2 0%

ported in 40% of all patients. Less weak- Deterioration No Change Improvement Spinal Cord Injuries

ness and a longer time of muscle activity


was reported in more than a quarter of the
treated patients. Better control of Bladder SCI – Results of Stem Cell Treatment
and Bowel and even getting back erecti- Efficacy by Complete or Incomplete Spinal Cord Injury (N=85)

ons was also reported by more than 10% Table: Improvements type of Spinal Cord Injury
of the patients. The results show no appa- (complete or incomplete lesion / N=85)

rent correlation between the outcome Improvements


Counts (%)
No improvements
Counts (%)
Total SCI patients
Counts (%)

and the used number of transplanted


stem cells. Complete SCI Injury 21 (67,7%) 10 (32,3%) 31 (100%)

Incomplete SCI Injury 30 (55,6%) 24 (44,4%) 54 (100%)


Conclusions
Total SCI patients 51 (60,0%) 34 (40,0%) 85 (100%)

In summary, Autologous Stem Cells injec-


ted in the spinal cavity has proven to have
a positive effect on the Spinal Cord Injury
by nearly 60% of the treated patients. Type of improvements SCI
Complete Spinal Cord Injuries (n=21/N=31)
100%

The used procedure is safe and the most 90%

reported complaint by the patients was a


80%

70%

short period of mild Headache. Compa- 60%

ring the results of the side effects survey of 50%

40%

XCell-Center (this survey consists of 350 30%

patients) with international literature, 20% No

10% Yes
XCell-Center showed one of the lowest in- 0%
28,6% 9,5% 28,6% 38,1% 28,6 % 52,4% 33,3% 23,8% 4,8%

cidence of Post Dural Puncture Headache


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References
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1. Dezawa M. Systematic neuronal and muscle induction systems in bone marrow stromal cells: the potential for tissue reconstruction in neurodegenerative
and muscle degenerative diseases. Medical molecular morphology. Mar 2008;41(1):14-19.

2. Deda H, Inci MC, Kurekci AE, Kayihan K, Ozgun E, Ustunsoy GE, Kocabay S. Treatment of chronic spinal cord injured patients with autologous bone
marrow-derived hematopoietic stem cell transplantation: 1-year follow-up. Cytotherapy. 2008;10(6):565-574.

3. Bakshi A, Barshinger AL, Swanger SA, Madhavani V, Shumsky JS, Neuhuber B, Fischer I. Lumbar puncture delivery of bone marrow stromal cells in spinal
cord contusion: a novel method for minimally invasive cell transplantation. Journal of neurotrauma. Jan 2006;23(1):55-65.

4. Mackay-Sim A, Feron F, Cochrane J, Bassingthwaighte L, Bayliss C, Davies W, Fronek P, Gray C, Kerr G, Licina P, Nowitzke A, Perry C, Silburn PA, Urquhart
S, Geraghty T. Autologous olfactory ensheathing cell transplantation in human paraplegia: a 3-year clinical trial. Brain. Sep 2008;131(Pt 9):2376-2386.

5. Frank RL. Lumbar puncture and post-dural puncture headaches: implications for the emergency physician. The Journal of emergency medicine. Aug
2008;35(2):149-157.