Name of journal: World Journal of Transplantation esps manuscript no: 18452 Manuscript Type: Original Article Retrospective Study


P-Reviewer: Liu L, Tanabe S S-Editor



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P-Reviewer: Liu L, Tanabe S S-Editor: Ji FF L-Editor: E-Editor:
Table 1 Sex, age, level of injury distribution of patients with traumatic disease of spinal cord (main group)

No. of patients

202 (1008 case histories)

Age

From 19 to 51 yr

Gender

Males - 156, females - 46

Years post injury

Less than 1 yr - 11

From 1 to 5 yr - 144

Over 5 yr - 47


Level of spinal cord injury

Cervical level - 93

Thoracic level - 98

Lumbar level - 11


Type of injury

Complete - 43

Incomplete - 159



No. of transplantations

No less than 20 HSCs and HPs transplantations

Average number of transplanted cells

5.8 ´ 106

HSCs: Hematopoietic stem cells; HPs: Hematopoietic precursors.



Table 2 Sex, age, level of injury distribution of patients with traumatic disease of spinal cord (control group)


No. of patients

20 (62 case histories)

Age

From 18 to 44 yr

Gender

Males - 13, females - 7

Years post injury

< 1 yr - 6

From 1 year to 5 - 10

Over 5 yr - 4


Level of spinal cord injury

Cervical level - 14

Thoracic level - 4

Lumbar level - 2


Type

Complete - 12

Incomplete - 8





Table 3 The characteristics and basic differences of the hematopoietic stem cells and hematopoietic precursors preparation from the preparation of hematopoietic stem cells used for bone marrow transplantation


Technique

G-CSF dose

Period of administration (d)

Stimulation regimen

Cell markers

Cryopreservant

Administration of HSCs in blood

10-20 µg/kg

6-7

1 in 24 h

CD34+, CD45+

HLA DR+, CD38+

Gp130±


10%-20% DMSO

Administration of HSC and HPs in CSF

5 µg/kg; double dose at day 4

5

2 in 24 h

CD34+, CD45-

HLA DR±, CD38±

Gp130+


5%-10% DMSO +

polyglucin


HSCs: Hematopoietic stem cells; HPs: Hematopoietic precursors; G-CSF: Granulocyte-colony stimulating factor.



Table 4 Clinical symptoms of the complications and side effects in spinal cord injury patients

Symptoms

Stages of research

Control group patients




1 stage

2 stage

3 stage




Increased spasticity

46%

49.9%

54.5%

0

Fever

15%

19%

18.8%

0

Post-puncture headache

11%

14.9%

12.2%

14.9%

High blood pressure

10%

8.1%

14.5%

0

Coordination disturbance

2.3%

1.3%

0

0

Dizziness

2%

3.4%

0

4.2%

Sleepiness

2.1%

1.7%

0

0

Emotional lability

1.6%

1.7%

0

0

Disordered consciousness

1.2%

0.8%

0.8%

0

Meningism

3.7%

2.95%

0.8%

0

Low blood pressure

1.68%

2.95%

5.9%

0

General % of the patients with complications

63.5%

72.9%

75%

19.1%





Figure 1 Obtaining cell preparations in various modes of granulocyte colony-stimulating factor stimulation.


Figure 2 General effectiveness of restoration of the spinal functions after hematopoietic stem cells and hematopoietic precursors transplantation.

A
B

C

Figure 3 General effectiveness (A), clinical progress (B) and clinical picture (C). A: General effectiveness of motor functions’ restoration after HSCs and HPs transplantation; B: Clinical progress in motor functions after HSCs and HPs transplantation; C: Clinical picture of motor functions after HSCs and HPs transplantation in SCI patients with different levels of injury. aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after 1 HSCs and HPs transplantation; eP < 0.05 as vs the score after 2 HSCs and HPs transplantations; bP < 0.1 as vs the baseline. HSCs: Hematopoietic stem cells; HPs: Hematopoietic precursors; SCI: Spinal cord injury.



Figure 4 Comparison of clinical motor restoration after hematopoietic stem cells and hematopoietic precursors transplantation among spinal cord injury patient with different injury levels. aP < 0.05 as vs the level С4-Th2; cP < 0.05 as vs the level Th3-Th8.


Figure 5 Motor function restoration after hematopoietic stem cells and hematopoietic precursors transplantation in complete spinal cord injury patients and incomplete. aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after the first transplantation; bP < 0.1 as vs the baseline.



Figure 6 Clinical progress of motor restoration after hematopoietic stem cells and hematopoietic precursors transplantation depending on years post injury. aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after the first transplantation; eP < 0.05 as vs the group of patients with 2-5 years post injury.



Figure 7 Muscle strength restoration evaluated by Medical Research Council Scale after hematopoietic stem cells and hematopoietic precursors transplantation. aP < 0.05 as vs the baseline.

A

B
Figure 8 Clinical picture of muscle strength restoration evaluated by the Medical Research Council Scale after Hematopoietic stem cells and Hematopoietic precursors transplantation in the patients with different levels of spinal cord injury (A) and complete and incomplete spinal cord injury (B). aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after 1 HSCs and HPs transplantation; bP < 0.1 as vs the baseline. HSCs: Hematopoietic stem cells; HPs: Hematopoietic precursors.


Figure 9 Clinical picture of muscle force restoration evaluated by Medical Research Council Scale after hematopoietic stem cells and hematopoietic precursors transplantation depending on years post injury. aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after 1 HSCs and HPs transplantation. HSCs: Hematopoietic stem cells; HPs: Hematopoietic precursors.

Figure 10 General efficiency of sensation restoration after hematopoietic stem cells and hematopoietic precursors transplantation.





Figure 11 Clinical changes in sensation after hematopoietic stem cells and hematopoietic precursors transplantation (A) in the spinal cord injury patients with different levels of injury (B) and in the patients with complete and incomplete spinal cord injury (C). aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after 1 transplantation; bP < 0.1 as vs the baseline.


Figure 12 Clinical progress of urinary restoration after hematopoietic stem cells and hematopoietic precursors transplantation. aP < 0.05 as vs the baseline.



Figure 13 Clinical changes of urinary function after hematopoietic stem cells and hematopoietic precursors transplantation at different levels of spinal cord injury. aP < 0.05 as vs compared to the baseline; cP < 0.05 as vs the score after the first transplantation.





Figure 14 Urinary restoration after hematopoietic stem cells and hematopoietic precursors transplantation in complete/incomplete spinal cord injury patients (A) and depending on years post spinal cord injury (B); motor restoration after hematopoietic stem cells and hematopoietic precursors transplantation evaluated by ISCISCI-92 (C). aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after 1 transplantation; bP < 0.1 as vs the baseline.


Figure 15 Changes of vital activity in the patients after hematopoietic stem cells and hematopoietic precursors transplantation measured by FIM. aP < 0.05 as vs the baseline; cP < 0.05 as vs the score after 1 HSCs and HPs transplantation. HSCs: Hematopoietic stem cells; HPs: Hematopoietic precursors.


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