Autologous bone marrow stromal cells transplantation for the treatment of secondary arm lymphedema: a prospective controlled study in patients with breast cancer related lymphedema.

摘要

OBJECTIVE: To determine the short- and long-term effect of bone marrow stromal cells (BMSCs) transplantation as a treatment for breast cancer-related lymphedema. To contrast it with complex decongestive physiotherapy (CDT). METHODS: Fifteen women with lymphedema, who had undergone breast cancer surgery ando radiotherapy 5 years before, served as the experimental group and received BMSC transplantation; 35 patients were measured as the control group treated with CDT. They were kept on follow-up for 1 year. RESULTS: Two patients in the CDT Group failed to keep follow-up. Before treatment, patients had average volume of edema in the affected arm of 1166.2 ml in BMSC Group and 1091.0 ml in the CDT Group. With therapy, there was an average decrease in lymphedema volume of 730.7, 887.9 and 958.6 ml in the BMSC Group and 714.8, 657.9 and 571.3 ml in the CDT Group after 1, 3 and 12 months, respectively. Before treatment, the percentage of lymphedema was 28.6% in the BMSC Group and 26.8% in the CDT Group. After treatment, there was a decrease of 64.6, 78.5 and 81.0% in the BMSC Group and 67.2, 60.4 and 54.5% in the CDT Group after 1, 3 and 12 months, respectively. When asked to quantify subjectively their pain on a numeric scale from 0 to 5, the average score of these patients was 3.4 in the BMSC group and 4.0 in the CDT Group. The average score was reduced to 1.6, 0.8 and 0.6 in the BMSC Group and to 1.2, 1.7 and 1.6 in CDT Group after 1, 3 and 12 months, respectively. CONCLUSIONS: Autologous BMSCs transplantation for the treatment of breast cancer related lymphedema is effective and feasible.