Simplified autologous hematopoietic stem cell transplantation shows promise in type 1 diabetes
In patients with type 1 diabetes, simplified autologous hematopoietic stem cell transplantation in an outpatient setting appears to be a safe and effective intervention, according to study data.
Fernando Lavalle-González, MD, an endocrinologist at the Universidad Autónoma de Nuevo León in Mexico, and colleagues evaluated 16 children (median age, 12 years) with type 1 diabetes to determine the effect of simplified autologous hematopoietic stem cell transplantation in the outpatient setting on long-term insulin independence, changes in HbA1c and the safety of the procedure. The median follow-up was 34 months.
All patients underwent the procedure on a 100% outpatient basis without severe complications, and there was no mortality at 100 days of follow-up.
The overall response was 81%, with a reduction in overall daily insulin requirements from 0.41 U/kg to 0.32 U/kg by the third month (P = .46). Insulin dependence was achieved by seven participants (44%); five were insulin-independent by the third month and one attained freedom from insulin within the first week after transplantation. Two participants who achieved partial insulin independence at 6 months postprocedure achieved complete insulin independence at 11 months and 1 year posttransplant. Three patients were deemed nonresponders, and the remaining six showed partial insulin independence. In all groups, HbA1c levels demonstrated a total mean decrease of 0.87% during the 3 months of study, a 1% decrease at 6 months and 1.6% decrease at the last follow-up. At 6 months, the insulin-independent group exhibited a mean HbA1c reduction of –2.3%.
“The transplant was fully accomplished on an outpatient basis, thereby reducing costs, limiting exposure to nosocomial infections and avoiding the inconvenience of hospitalization,” the researchers wrote. “This method should be further studied in a larger cohort including an appropriate contemporary control group as it appears to be capable of changing the natural history of type 1 diabetes mellitus.” – by Jennifer Byrne
Disclosure: The researchers report no relevant financial disclosures.