Transplante aut?logo de c?lulas-tronco de medula ?ssea em pacientes com trauma raquimedular

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Bibliographic Details
Main Author: Mendon?a, Marcus Vin?cius Pinheiro
Other Authors: Soares, Milena Botelho Pereira
Format: Others
Language:Portuguese
Published: Universidade Estadual de Feira de Santana 2015
Subjects:
Online Access:http://localhost:8080/tede/handle/tede/84
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Summary:Submitted by Natalie Mendes (nataliermendes@gmail.com) on 2015-07-24T01:11:42Z No. of bitstreams: 1 marcus_vinicius_pinheiro_mendonca_tese.pdf: 8890182 bytes, checksum: 8c3486b869dff02251529c805a28b23c (MD5) === Made available in DSpace on 2015-07-24T01:11:42Z (GMT). No. of bitstreams: 1 marcus_vinicius_pinheiro_mendonca_tese.pdf: 8890182 bytes, checksum: 8c3486b869dff02251529c805a28b23c (MD5) Previous issue date: 2014-10-10 === Despite the advancement in the care of patients with spinal cord injury, currently there is no specific treatment for neurological lesion. Therapy with mesenchymal stem cells from bone marrow (BMMC) has shown to be a safe and promising technique in various medical fields. The objective of this study is to evaluate the safety of autologous BMMC transplantation for the treatment of chronic spinal cord injury of traumatic origin.Fourteen paraplegic patients (classified as A in ASIA scale) with at least 6-month thoracic or thoracolumbar spinal cord injurywere selected. They underwent aspiration of bone marrow tissue from the iliac crest with further expansion and in vitro characterization; by means of microsurgical procedure, the BMMC suspension was introduced at the level of the spinal cord injury. A 6-month clinical follow-up was performed after surgery, including functional and imaging tests. There was a change in ASIA scale in 7 patients, increased bladder capacity in 5 patients and appearance of the SSEP waveform in one patient. Throughout the observation period, no major complications were observed. The present protocol proved to be safe and, due to significant improvements in neurological symptoms in many patients, also a potentially promising therapeutic method for patients with spinal cord injury. === A despeito do avan?o na assist?ncia do paciente com trauma raquimedular, atualmente n?o h? tratamento espec?fico para a les?o neurol?gica. A terapia com c?lulas-tronco mesenquimais da medula ?ssea (CMMO) tem-se mostrado uma t?cnica segura e promissora em diversas ?reas m?dicas. O objetivo deste estudo ? avaliar a seguran?a do transplante aut?logo de CMMO para o tratamento de les?o medular cr?nica de origem traum?tica. Foram selecionados 14 pacientes parapl?gicos (classificados como A na escala ASIA) com les?o medular tor?cica ou t?raco-lombar h? mais de 6 meses. Eles foram inicialmente submetidos ? aspira??o de tecido da medula ?ssea da crista il?aca, com posterior expans?o e caracteriza??o in vitro de CMMO e, por meio de procedimento microcir?rgico, introduziu-se a suspens?o de CMMO na medula espinhal no n?vel da les?o. Os pacientes foram acompanhados clinicamente, com realiza??o de exames funcionais e de imagem por um per?odo de 6 meses ap?s o procedimento cir?rgico. Houve mudan?a na escala ASIA em 7 pacientes, aumento da capacidade vesical em 5 pacientes e aparecimento de onda ao SSEP em 1 paciente. Durante todo o tempo de observa??o, n?o foram identificadas complica??es potencialmente graves. O presente protocolo se mostrou seguro e, ainda, devido a melhoras significativas no quadro neurol?gico em boa parte dos pacientes, um m?todo terap?utico potencialmente promissor para pacientes com trauma raquimedular.