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Stem cell transplantation in amyotrophic lateral sclerosis patients: methodological approach, safety, and feasibility

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DOI

  • Héctor R Martínez, Neurology Service, Hospital San Jose Tec de Monterrey, Monterrey, Nuevo Leon, Mexico. drhectormtz@yahoo.com
  • ,
  • Juan Francisco Molina-Lopez
  • ,
  • María Teresa González-Garza
  • ,
  • Jorge E Moreno-Cuevas
  • ,
  • Enrique Caro-Osorio
  • ,
  • Alfonso Gil-Valadez
  • ,
  • Eugenio Gutierrez-Jimenez
  • Oscar E Zazueta-Fierro
  • ,
  • J Alfonso Meza
  • ,
  • Patricio Couret-Alcaraz
  • ,
  • Martin Hernandez-Torre

Amyotrophic lateral sclerosis is characterized by the selective death of motor neurons. Stem cells have been proposed as a potential therapeutic strategy. The safety of stem cell transplantation into the frontal motor cortex to improve upper motor neuron function is described. Sixty-seven patients with definite amyotrophic lateral sclerosis were included. After giving their informed consent, the patients underwent magnetic resonance imaging, functional rating, pulmonary function test, and laboratory tests. Their bone marrow was stimulated with daily filgrastim (300 µg) given subcutaneously for 3 days. Peripheral blood mononuclear cells were obtained by leukapheresis. Isolated CD133(+) stem cells were suspended in 300 µl of the patient's cerebrospinal fluid and implanted into the motor cortex. Adverse events were recorded at each step of the procedure and were classified according to the Common Terminology Criteria for Adverse Events v3.0. The survival at 1 year was 90% after transplantation. with a mean long-term survival rate of 40.17 months from diagnosis. The most common adverse events were in grades I-II and involved transient skin pain (19.5% of patients) attributed to the insertion of the Mahurkar catheter into the subclavian vein, minor scalp pain (15.9%), and headache (12.2%) from the surgical procedure. Several patients (1.5 - 4.5%) reported diverse grade I adverse events. There were two deaths, one considered to be associated with the procedure (1.5%) and the other associated with the disease. Autologous stem cell transplantation into the frontal motor cortex is safe and tolerated well by patients. Further controlled studies are required to define the efficacy of this procedure.

Original languageEnglish
JournalCell Transplantation
Volume21
Issue9
Pages (from-to)1899-907
Number of pages9
ISSN0963-6897
DOIs
Publication statusPublished - 2012

    Research areas

  • Amyotrophic Lateral Sclerosis, Feasibility Studies, Female, Filgrastim, Granulocyte Colony-Stimulating Factor, Humans, Leukapheresis, Male, Mesenchymal Stem Cell Transplantation, Middle Aged, Motor Cortex, Recombinant Proteins, Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't

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