Autologous bone marrow–derived cells for venous leg ulcers treatment: a pilot study

Abstract Background Chronic venous leg ulcers (VLUs) are a common problem in clinical practice and available treatments are not satisfactory. The use of adjuvant therapies in combination with lower limb compression may lead to improved healing rates. Chronic wounds are candidates for new strategies...

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Published in:	Cytotherapy (Oxford, England) Vol. 21; no. 2; pp. 189 - 199
Main Authors:	OTERO, GABRIELA, AGORIO, CAROLINE, SUJANOV, ALEXANDRA, ECHARTE, LOURDES, TCHEKMEDYIAN, ANA, MONTELONGO, MONICA, MENYOU, ALBA, RODRIGUEZ, ANDRES, DIAZ, LILIAN, RODRIGUEZ, ISMAEL, TOURIÑO, CRISTINA
Format:	Journal Article
Language:	English
Published:	England Elsevier Inc 01-02-2019
Subjects:	Advanced Basic Science Aged Bone Marrow Transplantation - adverse effects Bone Marrow Transplantation - methods bone marrow–derived cells cell therapy chronic wounds healing Feasibility Studies Female Follow-Up Studies Humans Ilium - cytology Male Middle Aged Other Pilot Projects Prospective Studies regenerative medicine Regenerative Medicine - methods Transplantation, Autologous - methods Treatment Outcome Varicose Ulcer - therapy venous leg ulcers Wound Healing bone marrow–derived cells venous leg ulcers cell therapy regenerative medicine chronic wounds healing
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Summary:	Abstract Background Chronic venous leg ulcers (VLUs) are a common problem in clinical practice and available treatments are not satisfactory. The use of adjuvant therapies in combination with lower limb compression may lead to improved healing rates. Chronic wounds are candidates for new strategies in the emergent field of regenerative medicine. Bone marrow–derived cells (BMDCs) contain cells and secrete cytokines known to participate in wound healing. Thus, BMDC therapy seems a logical strategy for the treatment of chronic wounds. Our objective was to evaluate feasibility, safety and initial clinical outcome of autologous BMDC therapy associated with standard treatment in patients with VLUs. Methods We conducted an open-label, single-arm, prospective pilot clinical trial in four patients with six chronic VLUs. The study protocol was approved by the institutional and national review boards and ethics committees. Bone marrow was harvest, processed and then administered by multiple injections into the ulcers. All patients received standard treatment and non-healing characteristics of the VLUs were confirmed at study entry. Results Ulcer size and wound pain evaluated 12 months after BMDC treatment were significantly reduced ( P < 0.05). BMDC treatment was safe and well tolerated in long-term follow-up. Discussion Despite the low number of patients studied, our results showed that autologous BMDC treatment could be a useful, feasible and safe procedure to enhance ulcer healing. However, randomized controlled trials with more patients are needed to address this question and translate this approach into clinical practice.
Bibliography:	ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23
ISSN:	1465-3249 1477-2566
DOI:	10.1016/j.jcyt.2019.01.002