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Therapeutic effects and safety of autologous hematopoietic stem cell transplantation in Newly-diagnosed type 1 diabetic patients

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Author:
No author available
Journal Title:
CHINESE JOURNAL OF DIABETES
Issue:
10
DOI:
10.3969/j.issn.1006-6187.2010.10.007
Key Word:
1型糖尿病;造血干细胞移植;疗效;安全性;Type 1 diabetes;Hematopoietic stem cell transplantation;Therapeutic effects;Safety

Abstract: Objective To further determine the safety and therapeutic effects of autologous hematopoietic stem cell transplantation (HSCT) in newly diagnosed type 1 diabetes(T1DM)by enlarging sample size and following up. MethodsHematopoietic stem cells were mobilized with cyclophosphamide and granulocyte colonystimulating factor and then collected from peripheral blood by leukapheresis and cryopreserved.The cells were infused intravenously or by splenic arterial cannula after conditioning with cyclophosphamide and rabbit antithymocyte globulin. The daily exogenous insulin requirements, serum levels of hemoglobin A1c, islet β-cell function and anti-islet antibody titers were compared between pre-HSCT and different times following HSCT. The adverse effects during and after AHST were recorded. Results3 patients became insulin free for different periods. At 3, 6 and 12 months after AHST, mean levels of hemoglobin A1c were significantly lower(P<0.05)and mean levels of C-peptide were higher than before treatment. The above four islet antibodies became negative in all patients during different time after AHST. Hypothyroidism was diagnosed in one patient 6 months after AHST.There were no severe adverse effects such as myelosuppression and hemorrhagic cystitis. Conclusions After AHST, beta cell function is increased and blood glucose control is improved in all patients. But additional studies should be performed to confirm whether AHST can be routinely conducted in clinic.

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