• Miguel Blanquer, Jose M Moraleda, Francisca Iniesta, Joaquín Gómez-Espuch, José Meca-Lallana, Ramón Villaverde, Miguel Ángel Pérez-Espejo, Francisco José Ruíz-López, José María García Santos, Patricia Bleda, Virginia Izura, María Sáez, Pedro De Mingo, Laura Vivancos, Rafael Carles, Judith Jiménez, Joaquín Hernández, Julia Guardiola, Silvia Torres Del Rio, Carmen Antúnez, Pedro De la Rosa, Maria Juliana Majado, Andrés Sánchez-Salinas, Javier López, Juan Francisco Martínez-Lage, and Salvador Martínez.
• Hematopoietic Progenitors Transplant and Cell Therapy Unit, Hospital Virgen de la Arrixaca, Universidad de Murcia, Murcia, Spain.
• Stem Cells. 2012 Jun 1; 30 (6): 1277-85.

AbstractThe objective of this article is to assess the safety of intraspinal infusion of autologous bone marrow mononuclear cells (BMNCs) and, ultimately, to look for histopathological signs of cellular neurotrophism in amyotrophic lateral sclerosis (ALS) patients. We conducted an open single arm phase I trial. After 6 months observation, autologous BMNCs were infused into the posterior spinal cord funiculus. Safety was the primary endpoint and was defined as the absence of serious transplant-related adverse events. In addition, forced vital capacity (FVC), ALS-functional rating scale (ALS-FRS), Medical Research Council scale for assessment of muscle power (MRC), and Norris scales were assessed 6 and 3 months prior to the transplant and quarterly afterward for 1 year. Pathological studies were performed in case of death. Eleven patients were included. We did not observe any severe transplant-related adverse event, but there were 43 nonsevere events. Twenty-two (51%) resolved in ≤2 weeks and only four were still present at the end of follow-up. All were common terminology criteria for adverse events grade ≤2. No acceleration in the rate of decline of FVC, ALS-FRS, Norris, or MRC scales was observed. Four patients died on days 359, 378, 808, and 1,058 post-transplant for reasons unrelated to the procedure. Spinal cord pathological analysis showed a greater number of motoneurons in the treated segments compared with the untreated segments (4.2 ± 0.8 motoneurons per section [mns per sect] and 0.9 ± 0.3 mns per sect, respectively). In the treated segments, motoneurons were surrounded by CD90+ cells and did not show degenerative ubiquitin deposits. This clinical trial confirms not only the safety of intraspinal infusion of autologous BMNC in ALS patients but also provides evidence strongly suggesting their neurotrophic activity.Copyright © 2012 AlphaMed Press.

20 keywords...

hide…