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- Page navigation anchor for RE: Response to question re: Stem Cell TransplantsRE: Response to question re: Stem Cell Transplants
Dr Ganty,
Thank you for your interest in our article. We are excited about the potential of stem cells and look forward to much more high-quality, ethics-approved research. Our patient has no ongoing follow-up with Lima and colleagues; because he had no point of contact, we did not inform them of this complication.
As outlined in the article, we believe this to be the fourth case of mass lesion following olfactory mucosal autograft. Dlouhy and colleagues describe the same complication in another patient who underwent treatment in Portugal (see reference 10). After their case report was published, Lima's colleagues wrote a letter to the editor of the Journal of Neurosurgery Spine acknowledging this complication (see "Autograft-derived spinal cord mass," volume 24, April 2016, pages 673-4; reference 3, appendix 1, of our article). We understand that this group is no longer offering this procedure.
Thank you again for your interest.
Competing Interests: None declared. - Page navigation anchor for Letter to the Editor, response to: ‘Intramedullary cervical spinal mass after stem cell transplantation using an olfactory mucosal cell autograft’ by Woodworth et al. July 2019.Letter to the Editor, response to: ‘Intramedullary cervical spinal mass after stem cell transplantation using an olfactory mucosal cell autograft’ by Woodworth et al. July 2019.
Dear Editor,
Woodworth et al highlight a significant complication 12 years after a patient received a transplant of olfactory mucosa tissue into the spinal cord. This report, combined with others cited by the authors emphasises that long term follow-up after cell transplantation must be performed and reported as a matter of routine. This is essential for ensuring adequate patient safety, yet it is at odds with the short follow-up times specified by many current cell therapy trials.
We find it unsurprising that aberrant growth was observed after the transplantation of whole olfactory mucosa tissue. The olfactory mucosa is rich in a number of cell types [1], including the pseudostratified columnar epithelial cells noted on histology from this patient. In the original study by Lima et al, the use of whole tissue was justified because cell suspensions lead to poor cell viability and do not adequately fill the lesion space [2]. These concerns are justifiable [3], but we challenge the idea that transplanting whole tissue is the only way to overcome such issues. Indeed, we would like to draw attention to new approaches being developed by our group and others [4], where tissue engineering and biomaterial-based approaches have the potential to enhance the delivery of olfactory ensheathing cells.
Olfactory ensheathing cells still have great potential for treating spinal cord injuries [5], but this case reinforces the need for improved cell purification techniqu...
Show MoreCompeting Interests: Dr. Bartlett reports grants from The Sackler Fund (MB/PhD award), outside the submitted work. Dr. Phillips is the co-founder of the UCL spin-out company 'Glialign Ltd' which focuses on peripheral nerve repair (not spinal cord injury which is the subject of this response). Dr. Phillips has received no income from the company and is not a director. Dr. Phillips holds the following patents: WO 2015015185 and WO 2004087231. These are broadly in the area of organising therapeutic cells within hydrogels but are not linked to any of the studies reported in the manuscript. Dr. Choi reports support from UCL/UCLH NIHR Biomedical Research Centre, and grants from Wellcome Trust, outside the submitted work. - Page navigation anchor for RE: Stem Cell TransplantsRE: Stem Cell Transplants
Dear Editor,
I thank Dr.Woodworth and colleagues for highlighting the risks of stem cell therapy. As mentioned in the article, the claim of stem cell treatment has expanded to many areas of clinical practice, especially, in the world of chronic pain as a potential treatment for osteoarthritis.We need more studies to gauge the efficacy and to probably identify tissue markers to ensure that the stem cells transform into the desired tissue and the growth of other tissue types is arrested. We are about to embark on a clinical study in the use of stem cells in OA.
My question to the authors is: Did they inform Lima and colleagues about the hazardous complication that the patient developed, and if so, what was the response received?Competing Interests: None declared. - Page navigation anchor for RE: stem cellsRE: stem cells
Second article I have seen stating there are adverse effects,contrary to the many hyped books I have reviewed! Thanks!
Competing Interests: None declared.