Background and Objectives: Multiple Sclerosis is a disease characterized by multifocal areas of demyelination in the brain and spinal cord, with associated inflammatory cell infiltrates, reactive gliosis, and axonal degeneration. It typically presents in young adults with episodic neurologic dysfunction, our aim is to find new simple method to treat multiple sclerosis by hematopoietic stem cells derived from peripheral blood. Methods and Results: 50 patients suffering from multiple sclerosis worsening despite pharmacological treatment were treated by means of several intrathecal injections of peripheral blood cells harvested by aphaeresis after G-CSF(granulocyte colony stimulating factor) treatment. 24 patients (48%) had a reduction of EDSS score. 8 patients had a relapse, but it was milder than usual and more easily controlled by cortisone. Conclusions: Since mesenchymal cells increase in the peripheral blood after G-CSF stimulation, a peripheral blood harvest seems easier and cheaper than mesenchymal cells cultivation prior to the injection. It seems a reasonable treatment for progressive multiple sclerosis.
The aim was to determine the prevalence of compound genetic abnormalities in patients who are carriers of cystic fibrosis transmembrane regulator (CFTR) gene polymorphism and to compare our results with similar patients reported in the literature. One hundred and nine patients were identified to be carriers of CFTR gene polymorphism. Additional genetic testing for karyotype abnormalities or Y chromosome microdeletions (YMD) was performed. Three patients (2.75%) of 109 were identified to have compound genetic abnormalities. One patient had 5T/5T while the other had 6T/6T and the third had 9T/9T. The three patients had deletions of azoospermia factor regions (AZFa+b or AZFa+b+c). There were no karyotype abnormalities identified in our database. In the literature, four patients with compound CFTR mutations and YMD were identified, in three patients had karyotype abnormalities. In conclusion, compound genetic abnormalities in CFTR mutation patients can be a contributing factor when abnormal spermatogenesis is encountered.
In this study, we analyzed 70 patients with worsening multiple sclerosis despite pharmacologic treatment who were treated with several intrathecal injections of peripheral blood cells harvested by apheresis after granulocyte-colony stimulating factor treatment. Thirty-seven patients (52%) had a reduction of Expanded Disability Status Scale score; 10 patients had relapses, although these were milder than usual and more easily controlled by corticosteroids. Because mesenchymal cells increase in the peripheral blood after granulocyte-colony stimulating factor stimulation, a peripheral blood harvest seems easier and less costly than mesenchymal cell cultivation before injection. This seems to be a reasonable treatment for progressive multiple sclerosis.
Stroke is a leading cause of adult disability worldwide and the second highest cause of death in the world. Mortality rate is about 20% and another third are left with permanent disability. Treatments for stroke are based on methods that restore the flow of blood to the brain, such as clot-busting enzymes, surgery, and drugs for thinning blood, stopping clots and protecting neurons. Scientists believe that mesenchymal stem cell protection may be due to secretion of growth factors that promote growth of new neurons, regulate the immune system and stimulate the formation of new blood vessel, Or due to neurogenesis. Autologous bone marrow derived mononuclear cells with closed method is very near to minimal manipulation and low risk procedure.In this study, we aspirated 100 cc (mean volume) of bone marrow from 50 Iraqi adult patients (age ranges 34-86 years) (12 females 38 male) after filtration we injected 40 cc volume intravenously, mononuclear cell count was =5-6x10 7per product. The time from diagnosis till procedure performance was (3months-5 years), The effect of intravenous administration of autologous bone marrow mononuclear cells (BMMNCs) lead to improvement in European scale for stroke (+4-20) in 28 patients out of 50 (56%) in 4-8 weeks ). This study shows the positive effect of autologous bone marrow derived mononuclear cells in the functional recovery of adult patients with chronic ischemic stroke.
The Iraqi Bone Marrow Transplantation Center is located in the medical city complex of Bab Almuadham in Baghdad, Iraq. It was established on March 11, 2002, and performed its first mini-allotransplant for acute myeloid leukemia on January 24, 2003. Among 16 patients who received hematopoietic stem cell transplant between January 2003 and January 2010, one patient underwent allogeneic bone marrow transplant for acute myeloid leukemia and 15 patients received autologous bone marrow transplant for the following indications: 5 had multiple myeloma, 9 had lymphoma (8 with Hodgkin disease and 1 with non- Hodgkin lymphoma), and 1 had rhabdomyosarcoma. Median age was 34 years (range, 10-56 y), and our patient group included 8 females and 8 males. Of the 16 patients, 12 are still alive. The mortality rate was 25% as measured during our follow-up from 2 to 96 months. Of the 9 patients with lymphoma, 1 died and 2 relapsed after transplant. Therefore, our survival rate in lymphoma was 88%, with progression-free survival in lymphoma ranging from 2 to 66 months (mean survival of 13 mo, mode of 13 mo). For the 5 patients with multiple myeloma who received transplants, 1 died and 2 relapsed, with effective-free survival of 6 to 13 months. Our results show that high-dose chemotherapy followed by autologous stem cell transplant can induce long-term disease control in this cohort of patients with refractory or advanced Hodgkin disease; progression-free survival for our cohort was 50%, with survival comparable to those reported in the literature.
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