stroke recovery umbilical cord blood cells

WE ORGANIZE CLINICS FOR BRAIN STROKE RECOVERY TREATMENT

Umbilical cord blood cell infusion for stroke treatment

stem cell treatment for stroke recovery

GermanyHealth organizes treatments at a specialized clinic utilizing allogenic cord blood cells (umbilical cord blood cells) for stroke recovery treatment.

The clinic we are cooperating with, has experience in over 20 years in blood cord cell banking. Therefore, it may be the only clinic in Europe or worldwide providing cord blood infusions for individuals who have had an ischemic stroke.

stroke recovery stem cell therapy

ischemic_brain_stroke

What is an ischemic brain stroke

An ischemic brain stroke occurs when there is an interruption in blood flow in an artery, a blood vessel through which oxygenated blood from the lungs is pumped from the heart to the systemic circulation.

When this artery supplies blood to a circumscribed section of the brain, brain cells are deprived of oxygen and nutrients and can no longer function.

The person affected notices neurological symptoms or symptoms. As a result, these cells die within a few minutes and permanent functional impairments occur.

In General about Cord Blood Cell Infusion

In patients who have had a brain stroke, a therapeutic procedure involving an intravenous infusion of cord blood cells is used.

The umbilical cord blood for the infusion is obtained by taking it through the umbilical cord vein.

Therefore, a dose of 50 million cells per kg is necessary to achieve an optimal therapeutic effect. This roughly equates to 4 to 8 donors to achieve the required volume for the infusion.

The administration of the infusion is spread over 2-3 days. During the infusion and after the infusion, the patient is monitored for any side effects that may occur.

As has been shown, a slight improvement in cognitive and motor functions occurs in the majority of patients after administration of the umbilical cord blood infusions. However, the improvements of stroke recovery treatment with umbilical cord blood cells are noticeable within the first few weeks and last for 3 to 6 months.

The side effects of cord blood cell infusion are generally mild or non-existent.

The Effect of Treatment with Cord Blood Cells

brain stroke recovery treatment

To begin with, it must be said that the administration of umbilical cord blood by infusion is not a substitute for conventional neurological rehabilitation. Much more it is an additional approach to improve cognitive and motor functions.

If you are taking medication, there is no need to discontinue it during therapy. Physical rehabilitation can also be continued.

Intravenous cord blood cell infusions enhance the regenerative activity of brain cells in stroke patients. This is a significant and important aspect.

Clinical trials suggest that umbilical cord blood therapy is more effective when administered soon after stroke occurs.

After patients receive the infusion, they notice improvement within weeks. However, over the next 3 to 6 months, patients experience progressive improvement in their functional abilities. These newfound improvements are permanent and patients do not experience any worsening after cord blood cell therapy.

However, there may be little or no improvement in patients with severe functional impairment. Patients with mild or minimal impairment may experience modest improvement.

According to a clinical study, the most important factor is cell dosage. In patients with cerebral palsy induced after stroke, pediatric patients receiving more than 25 million cells per kg showed a significant therapeutic effect (Kurtzberg et al; Blood 2015).

Therefore, our patients receive more than 50 million cells per kg during the umbilical cord blood infusion.

Again, another study suggests that repeated cord blood infusion may lead to further functional improvements.

The Treatment Procedure with Umbilical Cord Blood Cells

Before / Initial / After

1.) Consultations before the procedure

The treatment begins with a detailed initial telephone or video consultation. This serves to collect a comprehensive anamnesis of the patient and to provide detailed information about the treatment by the doctors.

2.) Examinations

At the beginning, on the first day, some preliminary examinations must be carried out. This includes determining the blood group, if previously unknown. However, we ask for a lab test before you come to us to prepare everything.

Further, renal function must be assessed by standard biochemical tests. An echocardiogram is used to clarify the heart function. If abnormalities are found, further tests will be necessary to optimally clarify the cardiac status.

After the preliminary interview, examination, and baseline testing, the treating physician will propose a final treatment plan.

3.) During the procedure

In order to ensure the absolute patient compatibility of the umbilical cord blood units (CBU), double checks are carried out for your safety.

The treatment plan of each patient is individual. Therefore, the course of treatment is different for each patient. The infusion lasts between 20 minutes and 2 hours, depending on the number of units a patient receives.

Therefore, patients are supervised by a doctor during the time to monitor possible side effects.
A final examination ensures that you can leave the clinic safely.

One of the side effects can be a slight fishy breath odor that can last for about 24 hours. This is due to a small amount of dimethyl sulfoxide causing it. Dimethyl sulfoxide is a cytoprotective agent used in cryopreservation. However, it is diffused from the blood through the lungs.

The day after the treatment you will return to the clinic for another infusion and follow your treatment plan.

4.) After the procedure

Following the last infusion, there will be one final check-up with the treating physician. After completion of therapy, your doctor will be in contact over the next 6 months to monitor treatment effectiveness and any potential adverse effects.

Possible Risks

Any risks that can arise from a blood transfusion are usually rare and easily manageable.

Possible side effects that may occur:

Allergic reactions

The most commonly reported side effects may be allergic reactions, hives, fever and itching. However, these can be treated very well with medication. However, if side effects occur, the blood transfusion is stopped immediately.

Blood transfusion infections

Infectious agents, such as HIV or hepatitis B, that can be transmitted through cord blood is extremely rare, since the donated cord blood and maternal blood are examined by sensitive nucleoic acid tests. This is to ensure the safety of the blood.

Blood group AB0 incompatibility reaction

To ensure AB0 blood group compatibility, the umbilical cord blood units are carefully and precisely tested and matched to patients.

When comparing a standard blood transfusion to a cord blood infusion, cord blood transfusions are safer for three reasons:

a) A careful selection of the CBUs takes place through several control steps.

b) Most of the red blood cells have been removed from the cord blood units.

c) Only small amounts are administered by infusion over several days.

A mismatched cord blood transfusion is extremely unlikely. In this case, the response is minimal due to the small volume and minimal amount of transfused red blood cells.

Should an incompatibility nevertheless occur, the treatment will be stopped immediately and treated with medication.

Transfusion related graft versus host disease (TA GvHD)

When this happens, the bone marrow cells are attacked by white blood cells. However, this is mostly the case in patients undergoing chemotherapeutic treatment for hematological malignancies such as lymph nodes or leukemia.

However, severe immunodeficiency caused by disease and worsened by chemotherapy can prevent the patient’s immune system from clearing donated cells. This is usually several weeks after each transfusion. The resulting infection, such as the TA GvHD that occurs, often leads to the death of a patient.

Because the incidence is extremely rare, the exact frequency of this adverse event is not known. Based on published data and our estimate, TA GvHD occurs in less than 1 case in 7,000,000 blood transfusions.

The mechanical effect of the therapeutic effect

The mechanism of the therapeutic effect of umbilical cord blood cells is still unknown. It is assumed that the cord blood immune cells modulate the immune and regenerative activity of the patient’s cells. However, other umbilical cord blood cells, including thrombocytes, may also play a significant role in complex signaling.

Clinical research and studies

However, in order to get more certainty about the therapeutic effect of umbilical cord blood, further clinical studies are necessary. Therefore, in order to get FDA approval for infusion of umbilical cord cells, the phase 3 stroke clinical trial must be conducted in the USA. This could be submitted to the FDA by 2023.

At the moment, Prof. Dr. Kurtzberg of DUKE University in the US conducted a phase 2 clinical trial investigating giving patients a cord blood infusion up to 10 days after a stroke.

Preliminary published results showed improvement in all patients.

Financial Aspects

Costs

Total cost of the treatment is 40 000 EURO. This includes all consultations with our doctors before and after the treatment, all necessary medical evaluations before and after the treatment, umbilical cord blood from voluntary donors procurement provided by public cord blood registry, cord blood intravenous infusion procedure split to 2 or 3 days. Patient monitoring after the treatment including all laboratory and medical evaluations and follow-up consultations with our doctors for the duration of 12 months after the treatment are included.

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