• Title/Summary/Keyword: stem cell transplantation

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Hematopoietic stem cell transplantation in children with acute leukemia: similar outcomes in recipients of umbilical cord blood versus marrow or peripheral blood stem cells from related or unrelated donors

  • Yi, Eun-Sang;Lee, Soo-Hyun;Son, Meong-Hi;Kim, Ju-Youn;Cho, Eun-Joo;Lim, Su-Jin;Cheuh, Hee-Won;Yoo, Keon-Hee;Sung, Ki-Woong;Koo, Hong-Hoe
    • Clinical and Experimental Pediatrics
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    • v.55 no.3
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    • pp.93-99
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    • 2012
  • Purpose: This study compared outcomes in children with acute leukemia who underwent transplantations with umbilical cord blood (UCB), bone marrow, or peripheral blood stem cells from a human leukocyte antigen (HLA)-matched related donor (MRD) or an unrelated donor (URD). Methods: This retrospective study included consecutive acute leukemia patients who underwent their first allogeneic hematopoietic stem cell transplantation (HSCT) at Samsung Medical Center between 2005 and 2010. Patients received stem cells from MRD (n=33), URD (n=46), or UCB (n=41). Results: Neutrophil and platelet recovery were significantly longer after HSCT with UCB than with MRD or URD ($p$ <0.01 for both). In multivariate analysis using the MRD group as a reference, the URD group had a significantly higher risk of grade III to IV acute graft-versus-host disease (GVHD; relative risk [RR], 15.2; 95% confidence interval [CI], 1.2 to 186.2; $p$=0.03) and extensive chronic GVHD (RR, 6.9; 95% CI, 1.9 to 25.2; $p$ <0.01). For all 3 donor types, 5-year event-free survival (EFS) and overall survival were similar. Extensive chronic GVHD was associated with fewer relapses (RR, 0.1; 95% CI, 0.04 to 0.6; $p$ <0.01). Multivariate analysis showed that lower EFS was associated with advanced disease at transplantation (RR, 3.2; 95% CI, 1.3 to 7.8; $p$ <0.01) and total body irradiation (RR, 2.1; 95% CI, 1.0 to 4.3; $p$=0.04). Conclusion: Survival after UCB transplantation was similar to survival after MRD and URD transplantation. For patients lacking an HLA matched donor, the use of UCB is a suitable alternative.

In vitro maturation of human pluripotent stem cell-derived cardiomyocyte: A promising approach for cell therapy

  • Park, Yun-Gwi;Son, Yeo-Jin;Moon, Sung-Hwan;Park, Soon-Jung
    • Journal of Animal Reproduction and Biotechnology
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    • v.37 no.2
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    • pp.67-79
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    • 2022
  • Currently, there is no treatment to reverse or cure heart failure caused by ischemic heart disease and myocardial infarction despite the remarkable advances in modern medicine. In addition, there is a lack of evidence regarding the existence of stem cells involved in the proliferation and regeneration of cardiomyocytes in adult hearts. As an alternative solution to overcome this problem, protocols for differentiating human pluripotent stem cell (hPSC) into cardiomyocyte have been established, which further led to the development of cell therapy in major leading countries in this field. Recently, clinical studies have confirmed the safety of hPSC-derived cardiac progenitor cells (CPCs). Although several institutions have shown progress in their research on cell therapy using hPSC-derived cardiomyocytes, the functions of cardiomyocytes used for transplantation remain to be those of immature cardiomyocytes, which poses a risk of graft-induced arrhythmias in the early stage of transplantation. Over the last decade, research aimed at achieving maturation of immature cardiomyocytes, showing same characteristics as those of mature cardiomyocytes, has been actively conducted using various approaches at leading research institutes worldwide. However, challenges remain in technological development for effective generation of mature cardiomyocytes with the same properties as those present in the adult hearts. Therefore, in this review, we provide an overview of the technological development status for maturation methods of hPSC-derived cardiomyocytes and present a direction for future development of maturation techniques.

Reduction of Inflammation and Enhancement of Motility after Pancreatic Islet Derived Stem Cell Transplantation Following Spinal Cord Injury

  • Karaoz, Erdal;Tepekoy, Filiz;Yilmaz, Irem;Subasi, Cansu;Kabatas, Serdar
    • Journal of Korean Neurosurgical Society
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    • v.62 no.2
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    • pp.153-165
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    • 2019
  • Objective : Spinal cord injury (SCI) is a very serious health problem, usually caused by a trauma and accompanied by elevated levels of inflammation indicators. Stem cell-based therapy is promising some valuable strategies for its functional recovery. Nestin-positive progenitor and/or stem cells (SC) isolated from pancreatic islets (PI) show mesenchymal stem cell (MSC) characteristics. For this reason, we aimed to analyze the effects of rat pancreatic islet derived stem cell (rPI-SC) delivery on functional recovery, as well as the levels of inflammation factors following SCI. Methods : rPI-SCs were isolated, cultured and their MSC characteristics were determined through flow cytometry and immunofluorescence analysis. The experimental rat population was divided into three groups : 1) laminectomy & trauma, 2) laminectomy & trauma & phosphate-buffered saline (PBS), and 3) laminectomy+trauma+SCs. Green fluorescent protein (GFP) labelled rPI-SCs were transplanted into the injured rat spinal cord. Their motilities were evaluated with Basso, Beattie and Bresnahan (BBB) Score. After 4-weeks, spinal cord sections were analyzed for GFP labeled SCs and stained for vimentin, $S100{\beta}$, brain derived neurotrophic factor (BDNF), 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase), vascular endothelial growth factor (VEGF) and proinflammatory (interleukin [IL]-6, transforming growth factor $[TGF]-{\beta}$, macrophage inflammatory protein [MIP]-2, myeloperoxidase [MPO]) and anti-inflammatory (IL-1 receptor antagonis) factors. Results : rPI-SCs were revealed to display MSC characteristics and express neural and glial cell markers including BDNF, glial fibrillary acidic protein (GFAP), fibronectin, microtubule associated protein-2a,b (MAP2a,b), ${\beta}3$-tubulin and nestin as well as anti-inflammatory prostaglandin E2 receptor, EP3. The BBB scores showed significant motor recovery in group 3. GFP-labelled cells were localized on the injury site. In addition, decreased proinflammatory factor levels and increased intensity of anti-inflammatory factors were determined. Conclusion : Transplantation of PI-SCs might be an effective strategy to improve functional recovery following spinal cord trauma.

Xenotransplantation of Pig Spermatogonia into Mouse Testis

  • 이미숙;최윤정;권득남;김진회
    • Proceedings of the KSAR Conference
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    • 2003.06a
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    • pp.82-82
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    • 2003
  • The objective of the present study was to investigate the survival effect after transplantation of pig spermatogonia cells into mouse testis. Donor cells were collected from porcine testis and the isolated spermatogonial stem cells were labeled with a fluorescent marker before transplantation and transplanted into testes of busulfan-treated recipient mice. Testes were examined for the presence and localization of labeled donor cells immediately after transplantation or every week for 4 wk. Transplanted germ cells were present in the seminiferous epithelium at 4 weeks after the transplantation, but any differentiating porcine-derived cells were not detected in mouse testis. These results indicate that porcine-derived spermatogonial stem cells can be survived in the recipient, but suggest that porcine-derived male stem cells can not proceed to further differentiating step without helping of immunosuppressor agents.

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Perceived Anxiety and Uncertainty in Hematopoietic Stem Cell Transplantation Recipients to and from Isolation Unit (격리병동 입.퇴실시 조혈모세포 이식 환자가 지각하는 불안과 불확실성)

  • Kim, Hye-Jo;Choi, Dong-Won;Park, Ho-Ran;Sohng, Kyeong-Yae
    • Journal of Korean Academy of Fundamentals of Nursing
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    • v.13 no.3
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    • pp.428-436
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    • 2006
  • Purpose: To investigate the levels of uncertainty and anxiety at admission and discharge to the isolation unit for patients undergoing hematopoietic stem cell transplantation (HSCT). Method: The data were collected from 60 patients who were admitted to the department of HSCT. Uncertainty and anxiety were assessed using the Mishel Uncertainty in Illness Scale (MUIS) and Anxiety Inventory (STAI). Collected data were analyzed using the SAS program. Results: The mean score for anxiety at admission was 2.20, and at discharge 2.10. The mean score for uncertainty at admission was 2.19, and at discharge 2.07. The anxiety at admission the group with physical discomfort was higher than that of group without physical discomfort. A positive relationship was found between anxiety and uncertainty at admission and at discharge. The major variables were expectation for cure and physical discomfort, explaining 25.87% of the anxiety at admission. The major variable was expectation for cure, explaining 20.94% of the uncertainty at admission. Conclusion: Front the above results, it can be concluded that support and consideration are required to reduce anxiety of the inpatient in single room.

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Factors Influencing Changes in Quality of Life in Patients undergoing Hematopoietic Stem Cell Transplantation: A Longitudinal and Multilevel Analysis (다층모형을 적용한 조혈모세포이식 환자의 삶의 질 변화 영향요인)

  • Song, Chi Eun;So, Hyang Sook
    • Journal of Korean Academy of Nursing
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    • v.45 no.5
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    • pp.694-703
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    • 2015
  • Purpose: This study was a prospective longitudinal study to identify changes in quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation (HSCT). It was based on Roy's adaptation model. Methods: The questionnaires were administered before HSCT, 30 and 100 days after HSCT. Of the 48 potentially eligible patients, 44 (91.7%) participated in the study and 40 (90.9%) completed the questionnaires at 100 days after HSCT. Multilevel analysis was applied to analyze changes in quality of life. Results: Overall, quality of life showed a decreasing tendency from pre-HSCT to 100 days after HSCT. The adaptation level of participants was compensatory. Type of conditioning was the significant factor influencing quality of life before HSCT (${\beta}_{00}$=79.92, p <.001; ${\beta}_{01}$= - 12.64, p <.001) and the change rate of quality of life (${\beta}_{10}$= - 1.66, p =.020; ${\beta}_{11}$=2.88, p =.014). Symptom severity (${\beta}_{20}$= - 1.81, p =.004), depression (${\beta}_{30}$= - 0.58, p =.001), social dependency (${\beta}_{40}$= - 0.35, p =.165), and loneliness (${\beta}_{50}$= - 0.23, p =.065) had a negative effect on changes in quality of life. Symptom severity and depression were statistically significant factors influencing changes in quality of life. Conclusion: According to the results of this study, the development of nursing intervention is needed to improve quality of life in patients undergoing allogeneic hematopoietic stem cell transplantation in the early immune reconstruction period. The interventions should include programs to enhance coping capacity and programs to help control symptom severity and depression. Also these interventions need to be started from the beginning of HSCT and a multidisciplinary approach would be helpful.

The Effect of Aerobic Exercise Program on Health Status and Physical Fitness in Patients after the Stem Cell Transplantation (유산소 운동이 조혈모세포이식자의 건강상태와 체력에 미치는 효과)

  • Han, Shin-Hi
    • The Korean Journal of Rehabilitation Nursing
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    • v.4 no.1
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    • pp.7-19
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    • 2001
  • The Objectives of this research is to determine the effect of aerobic exercise program on health status and physical fitness in patients after the stem cell transplantation. This research design is one-group pretest-post test design. Sixteen subjects were selected from one university hospital in Seoul for the study, they was carried out aerobic exercise three to five times a week for 12 weeks. The period of data collection was from February to July, 2000. The collected data was analysed by descriptive analysis, paired t-test, content analysis SAS program was used for the statistical analysis. The results are as follows : 1. There was a significant improvement in the Physical functioning, Vitality and Reported change (t=2.39, p=0.03; t=2.35, p=0.03; t=2.58, p=0.02) but no change was observed in the Role physical, General health perception, Bodily pain, Social functioning, Role emotional and Mental health. 2. There was a significant improvement in the physical fitness (higher VO2 max, t=2.43, p=0.02; lower systolic pressure, t=-4.09, p=0.001; lower diastolic pressure, t=-3.43, p=0.002; lower pulse rate, t=-3.43, p=0.004; higher muscle sustaining power, t=2.79, p=0.015; higher muscle power, t=5.18 p=0.000; higher power of beginning, t=5.55, p=0.001; higher the sense of equilibrium, t=3.57, p=0.003; higher Hemoglobin, t=5.92, p=0.000; higher Hematocrit, t=5.38, p=0.000). Therefore, this study will provide a theoretical back ground for patients after stem cell transplantation to understand the importance of physical exercise and maintain physical exercise; and for other researches to refer to the results for exercise protocol of rehabilitation program.

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Total lymphoid irradiation based conditioning for hematopoietic stem cell transplantation in severe aplastic anemia

  • Lee, Yun-Hee;Kim, Ji-Yoon;Choi, Byung-Ock;Ryu, Mi-Ryeong;Chung, Su-Mi
    • Radiation Oncology Journal
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    • v.30 no.4
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    • pp.165-172
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    • 2012
  • Purpose: To retrospectively evaluate the outcome and toxicity of total lymphoid irradiation (TLI) based conditioning regimen for allogeneic hematopoietic stem cell transplantation (HSCT) in severe aplastic anemia (SAA) patients who experienced an engraftment failure from prior HSCT or were heavily transfused. Materials and Methods: Between 1995 and 2006, 20 SAA patients received TLI for conditioning of HSCT. All patients were multi-transfused or had long duration of disease. Fifteen (75%) patients had graft failure from prior HSCT. In 18 (90%) patients, the donors were human leukocyte antigen identical siblings. The stem cell source was the peripheral blood stem cell in 15 (75%) patients. The conditioning regimen was composed of antithymocyte globulin plus TLI with a median dose of 750 cGy in 1 fraction. The graft-versus-host disease (GVHD) prophylaxis used cyclosporine with methotrexate. Results: With a median follow-up of 10.8 years, graft failures developed in 6 patients. Among them, 3 patients received their third HSCT to be engrafted finally. The Kaplan-Meier overall survival rate was 85.0% and 83.1% at 5 and 10 years, respectively. The incidence of acute and chronic GVHD was 20% and 20%, respectively. None of the patients have developed a malignancy after HSCT. Conclusion: In our study, TLI based conditioning in allogeneic HSCT was feasible with acceptable rates of GVHD in SAA patients who experienced graft failure from prior HSCT or was at a high risk of graft rejection. We achieved relatively better results of engraftment and survival with a long term follow-up.