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

( views:156, downloads:0 )
Author:
LI Li-rong()
SHEN Shan-mei()
SHANGGUAN Hai-yan()
()
()
()
Journal Title:
CHINESE JOURNAL OF DIABETES
Issue:
Volume 18, Issue 10, 2010
DOI:
10.3969/j.issn.1006-6187.2010.10.007
Key Word:

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.

  • [1]Steffes MW,Sibley S,Jackson M,et al.Beta cell function and the development of diabetesrelated complications in the diabetes control and complications trial.Diabetes Care.2003,26:832-836.
  • [2]Boris N,Yasuo T,Igor L,et al..Mixed hematopoietic chimerism allows cure of autoimmune diabetes through allogeneic tolerance and reversal of autoimmunity.Diabetes,2004,53:376-383.
  • [3]Hess D,Li L,Martin M,et al.Bonemarrow-derived stem cells initiate pancreatic regeneration.Nat Biotechnol,2003,21:763-766.
  • [4]Voltarelli JC,Couri EB,Boris N,et al.Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus.JAMA,2007,297:1568-1577.
  • [5]Couri EB,Oliveira CB,Stracieri BP,et al.C-Peptide levels and insulin independence following autologous nonmyeloablatire hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus.JAMA,2009,301:1573-1579.
  • [6]沈山梅,李莉蓉,朱大龙,等.自体造血干细胞移植治疗1型糖尿病--附一例报告.中国糖尿病杂志,2008,16:455-457.
  • [7]Beilhack GF,Landa RR,Masek MA,etal.Prevention of type 1diabetes with major histocompatibility complex-compatible and nonmarrow ablative hematopoietic stem cell transplants.Diabetes,2005,54:1770-1779.
  • [8]Hosszufalusi N,Vatay A,Rajczy K,et al.Similar gnentic features and different islet cell autoantibody pattern of latent autoimmune diabetes in adults(LADA)compared with adult-onset type 1 diabetes with rapid progression.Diabetes Care,2003,26:452-457.
WanfangData CO.,Ltd All Rights Reserved
About WanfangData | Contact US
Healthcare Department, Fuxing Road NO.15, Haidian District Beijing, 100038 P.R.China
Tel:+86-010-58882616 Fax:+86-010-58882615 Email:yiyao@wanfangdata.com.cn