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2017 ; 26
(6
): 1059-1066
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Long-Term Follow-Up of Patients After Autologous Bone Marrow Cell Infusion for
Decompensated Liver Cirrhosis
#MMPMID28120743
Kim JK
; Kim SJ
; Kim Y
; Chung YE
; Park YN
; Kim HO
; Kim JS
; Park MS
; Sakaida I
; Kim DY
; Lee JI
; Ahn SH
; Lee KS
; Han KH
Cell Transplant
2017[Jun]; 26
(6
): 1059-1066
PMID28120743
show ga
Although several human clinical trials using various bone marrow-derived cell
types for cirrhotic or decompensated patients have reported a short-term benefit,
long-term follow-up data are limited. We analyzed the long-term clinical outcomes
of autologous bone marrow cell infusion (ABMI) for decompensated liver cirrhosis
(LC). Patients enrolled in a pilot single-armed ABMI study were followed up more
than 5 years. Bone marrow-derived mononuclear cells (BM-MNCs) from decompensated
LC were harvested and after processing were infused into a peripheral vein. The
laboratory test results and long-term clinical course including liver
transplantation (LT), development of cancer, cause of death, and survival after
ABMI were analyzed. Nineteen patients were followed up for a median of 66 months
after ABMI. Liver function, including serum levels of albumin and Child-Pugh (CP)
score, was improved at the 1-year follow-up. Liver volume was significantly
greater, cirrhosis was sustained, and collagen content was decreased at the
6-month follow-up. Five years after ABMI, five patients (26.3%) maintained CP
class A without LT or death, and five patients (26.3%) had undergone elective LT.
Hepatocellular carcinoma (HCC) occurred in five patients (26.3%), and lymphoma
and colon cancer occurred in one patient each. Three patients (15.8%) were lost
to follow-up at months 22, 31, and 33, respectively, but maintained CP class A
until their last follow-up. Five patients expired due to infection. While
improved liver function was maintained in some patients for more than 5 years
after ABMI, other patients developed HCC. Further studies of long-term follow-up
cohorts after cell therapy for LC are warranted.
free
free
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