Background
Methods
Patients
Inclusion criteria
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Sex: either sex.
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Age: from 2 to 15 years.
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Gross Motor Function Classification System [37] score: between level II and level V.
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Previous history of icterus during the neonatal period.
Exclusion criteria
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Coagulation disorder.
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Severe health condition such as cancer; failure of the heart, lungs, liver, or kidneys; or an active infection.
Study design
Research setting and duration
Sample size
Clinical assessment
Laboratory and imaging diagnostics
Isolation of BMMCs
Transplantation of BMMCs
Rehabilitative therapy
Statistical analysis
Results
Patients’ characteristics
GMFCS level | Number | Percentage |
---|---|---|
II | 2 | 8.0 |
III | 3 | 12.0 |
IV | 6 | 24.0 |
V | 14 | 56.0 |
Gross motor function and muscle tone at baseline and at 6 and 12 months after stem cell transplantation
Baseline Median (IQR) | 6 months post-transplantation Median (IQR) | p-value at 6 months | 12 months post-transplantation Median (IQR) | p-value at 12 months | |
---|---|---|---|---|---|
Total GMFM-88 score | 18.3 (17.6) | 35.8 (27.6) | 0.0003 | 53.2 (28.2) | 0.0000 |
Lying and rolling | 34.0 (26.0) | 48.0 (10.0) | 0.0011 | 51.0 (2.0) | 0.0000 |
Sitting | 15.0 (24.0) | 38.0 (31.0) | 0.0003 | 56.0 (9.0) | 0.0000 |
Crawling and kneeling | 0.0 (5.0) | 9.0 (28.0) | 0.0001 | 29.0 (27.0) | 0.0000 |
Standing | 0.0 (0.0) | 0.0 (4.0) | 0.0084 | 3.0 (14.0) | 0.0003 |
Walking, running and jumping | 0.0 (0.0) | 0.0 (0.0) | 0.0256 | 0.0 (5.0) | 0.0084 |
GMFM-66 score | 26.7 (14.8) | 38.4 (12.9) | 0.0003 | 45.6 (10.7) | 0.0000 |
GMFM-66 percentile | 19.3 (19.6) | 22.5 (22.6) | 0.0002 | 40.1 (5.5) | 0.0000 |
Ashworth score | 4.0 (0.25) | 3.3 (0.63) | 0.0000 | 3.0 (0.25) | 0.0000 |
Relationships between patient characteristics and changes in gross motor function and muscle tone
Characteristics | Change in GMFM-88 score Mean [95% CI] | Change in GMFM-66 percentile Mean [95% CI] | Change in Ashworth score Mean [95% CI] | |||
---|---|---|---|---|---|---|
Gendera | ||||||
Male | 32.4 [25.2; 39.5] | p-value = 0.808 | 20.2 [16.7; 23.6] | p-value = 0.593 | 1.0 [0.7; 1.2] | p-value = 0.301 |
Female | 31.1 [26.8;36.9] | 18.7 [13.5; 23.9] | 0.8 [0.3; 1.2] | |||
Ageb | ||||||
< 36 months | 37.1 [31.9; 42.3] | p-value = 0.368 | 21.7 [16.2; 27.1] | p-value = 0.776 | 0 | p-value = 0.393 |
36–72 months | 30.9 [22.4; 39.5] | 17.9 [13.7; 22.1] | 0.8 [0.6; 1.0] | |||
> 72 months | 31.9 [25.1; 38.7] | 21.0 [17.1; 25.0] | 0.9 [0.5; 1.4] | |||
GMFCSb | ||||||
Level II | 8.9 [6.0; 11.8] | p-value = 0.574 | 9.6 [1.1; 18.1] | p-value = 0.929 | 0.8 [0.7; 0.9] | p-value = 0.316 |
Level III | 21.1 [12.6; 29.5] | 13.9 [6.9; 20.8] | 0.6 [0.04; 1.2] | |||
Level IV | 39.5 [31.8; 47.2] | 18.6 [15.0; 22.2] | 1.0 [0.9; 1.0] | |||
Level V | 34.2 [28.9; 39.4] | 22.6 [19.5; 25.7] | 0.9 [0.6; 1.3] |