Abstract
Background:Autologous bone marrow stem cell transplantation without immune suppression has been proposed as a safe and efficient therapeutic option to replace β-cell mass destroyed by specific antibodies in chronic type 1 diabetes but we have not scientific information about how long the metabolic stability is maintained. Material and Method: From 2010 to 2014, were included 134 chronic type 1 diabetics patients (p.) in an autologous bone marrow stem cell transplantation protocol, stimulated with filgrastim, without immune suppression, c peptide Results:C peptide, 6 months after transplantation more than 0.9 ng/ml in 61 patients (45%) (P = 0.001, CI = 95%). At 12 months 50 patients (37%) (P = 0.001, CI = 95%). At 24 months 53 patients (39%) (P = 0.001, CI = 95%). At 36 months 51 patients (38%) (P = 0.001, CI = 95%). A1C before transplant, Conclusion:Autologous bone marrow stem cell transplantation, without immunosuppression, improves pancreatic function and metabolic control without new immune reaction after three years of follow up in chronic type 1 diabetic patients.
Highlights
In type 1 diabetes, significant destruction of b-cells by specific antibodies occurs prior to diagnosis
In 2010 we modified the technique achieving a significant increase in the extracted volume, we improved the numbers of cells recovered from the bone marrow and made the transplant by endovenous systemic infusion
The situation will not improve in the few years; even will be worse according to American Diabetes Association estimates
Summary
In type 1 diabetes, significant destruction of b-cells by specific antibodies occurs prior to diagnosis. Autologous bone marrow stem cell transplantation without immune suppression has been proposed as a safe and efficient therapeutic option to replace β-cell mass destroyed by specific antibodies in chronic type 1 diabetes but we have not scientific information about how long the metabolic stability is maintained. Material and Method: From 2010 to 2014, were included 134 chronic type 1 diabetics patients (p.) in an autologous bone marrow stem cell transplantation protocol, stimulated with filgrastim, without immune suppression, c peptide < 0.5 ng/ml and pancreatic antibodies negatives, without diabetes complications. C peptide, A1C, pancreatic islets and GAD antibodies and insulin dose at 6, 12, 24 and 36 months were performed. Conclusion: Autologous bone marrow stem cell transplantation, without immunosuppression, improves pancreatic function and metabolic control without new immune reaction after three years of follow up in chronic type 1 diabetic patients
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