Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema: Lymphoscintigraphic evaluation with 1 year of follow-up

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Resumé

Background: Breast cancer-related lymphedema (BCRL) is a feared late complication. Treatment options are lacking at present. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with adipose-derived regenerative cells (ADRCs) for treating BCRL with 1 year of follow-up. Material and methods: We included 10 patients with BCRL. ADRCs were injected directly into the axillary region together with a scar-releasing fat grafting procedure. Primary endpoint was change in arm volume. Secondary endpoints were change in patient-reported outcomes, changes in lymph flow, and safety. Results: During follow-up, no significant change in volume was noted. Patient-reported outcomes improved significantly with time. Five patients reduced their use of conservative management. Quantitative lymphoscintigraphy did not improve on the lymphedema-affected arms. ADRCs were well tolerated, and only minor transient adverse events related to liposuction were noted. Conclusions: In this pilot study, a single injection of ADRCs improved lymphedema based on patient-reported outcome measures, and there were no serious adverse events during the follow-up period. Lymphoscintigraphic evaluation showed no improvement after ADRC treatment. There was no change in excess arm volume. Results of this trial need to be confirmed in randomized clinical trials.

SprogEngelsk
TidsskriftJournal of Plastic, Reconstructive and Aesthetic Surgery
Vol/bind72
Udgave nummer1
Sider71-77
ISSN1748-6815
DOI
StatusUdgivet - jan. 2019

Fingeraftryk

Adipocytes
Lymphedema
Lymphoscintigraphy
Lipectomy
Mesenchymal Stromal Cells
Randomized Controlled Trials
Fats
Breast Cancer Lymphedema
Safety

Emneord

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    @article{03442b627418414d9c46e59aa5343f37,
    title = "Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema: Lymphoscintigraphic evaluation with 1 year of follow-up",
    abstract = "Background: Breast cancer-related lymphedema (BCRL) is a feared late complication. Treatment options are lacking at present. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with adipose-derived regenerative cells (ADRCs) for treating BCRL with 1 year of follow-up. Material and methods: We included 10 patients with BCRL. ADRCs were injected directly into the axillary region together with a scar-releasing fat grafting procedure. Primary endpoint was change in arm volume. Secondary endpoints were change in patient-reported outcomes, changes in lymph flow, and safety. Results: During follow-up, no significant change in volume was noted. Patient-reported outcomes improved significantly with time. Five patients reduced their use of conservative management. Quantitative lymphoscintigraphy did not improve on the lymphedema-affected arms. ADRCs were well tolerated, and only minor transient adverse events related to liposuction were noted. Conclusions: In this pilot study, a single injection of ADRCs improved lymphedema based on patient-reported outcome measures, and there were no serious adverse events during the follow-up period. Lymphoscintigraphic evaluation showed no improvement after ADRC treatment. There was no change in excess arm volume. Results of this trial need to be confirmed in randomized clinical trials.",
    keywords = "Adipose-derived regenerative cells, Breast cancer-related lymphedema, Lymphoscintigraphy, Pilot study, Stromal vascular fraction",
    author = "Toyserkani, {N. M.} and Jensen, {C. H.} and S. Tabatabaeifar and J{\o}rgensen, {M. G.} and S. Hvidsten and Simonsen, {J. A.} and Andersen, {D. C.} and Sheikh, {S. P.} and S{\o}rensen, {J. A.}",
    year = "2019",
    month = "1",
    doi = "10.1016/j.bjps.2018.09.007",
    language = "English",
    volume = "72",
    pages = "71--77",
    journal = "Journal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)",
    issn = "1748-6815",
    publisher = "Churchill Livingstone",
    number = "1",

    }

    TY - JOUR

    T1 - Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema

    T2 - Journal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)

    AU - Toyserkani, N. M.

    AU - Jensen, C. H.

    AU - Tabatabaeifar, S.

    AU - Jørgensen, M. G.

    AU - Hvidsten, S.

    AU - Simonsen, J. A.

    AU - Andersen, D. C.

    AU - Sheikh, S. P.

    AU - Sørensen, J. A.

    PY - 2019/1

    Y1 - 2019/1

    N2 - Background: Breast cancer-related lymphedema (BCRL) is a feared late complication. Treatment options are lacking at present. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with adipose-derived regenerative cells (ADRCs) for treating BCRL with 1 year of follow-up. Material and methods: We included 10 patients with BCRL. ADRCs were injected directly into the axillary region together with a scar-releasing fat grafting procedure. Primary endpoint was change in arm volume. Secondary endpoints were change in patient-reported outcomes, changes in lymph flow, and safety. Results: During follow-up, no significant change in volume was noted. Patient-reported outcomes improved significantly with time. Five patients reduced their use of conservative management. Quantitative lymphoscintigraphy did not improve on the lymphedema-affected arms. ADRCs were well tolerated, and only minor transient adverse events related to liposuction were noted. Conclusions: In this pilot study, a single injection of ADRCs improved lymphedema based on patient-reported outcome measures, and there were no serious adverse events during the follow-up period. Lymphoscintigraphic evaluation showed no improvement after ADRC treatment. There was no change in excess arm volume. Results of this trial need to be confirmed in randomized clinical trials.

    AB - Background: Breast cancer-related lymphedema (BCRL) is a feared late complication. Treatment options are lacking at present. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with adipose-derived regenerative cells (ADRCs) for treating BCRL with 1 year of follow-up. Material and methods: We included 10 patients with BCRL. ADRCs were injected directly into the axillary region together with a scar-releasing fat grafting procedure. Primary endpoint was change in arm volume. Secondary endpoints were change in patient-reported outcomes, changes in lymph flow, and safety. Results: During follow-up, no significant change in volume was noted. Patient-reported outcomes improved significantly with time. Five patients reduced their use of conservative management. Quantitative lymphoscintigraphy did not improve on the lymphedema-affected arms. ADRCs were well tolerated, and only minor transient adverse events related to liposuction were noted. Conclusions: In this pilot study, a single injection of ADRCs improved lymphedema based on patient-reported outcome measures, and there were no serious adverse events during the follow-up period. Lymphoscintigraphic evaluation showed no improvement after ADRC treatment. There was no change in excess arm volume. Results of this trial need to be confirmed in randomized clinical trials.

    KW - Adipose-derived regenerative cells

    KW - Breast cancer-related lymphedema

    KW - Lymphoscintigraphy

    KW - Pilot study

    KW - Stromal vascular fraction

    U2 - 10.1016/j.bjps.2018.09.007

    DO - 10.1016/j.bjps.2018.09.007

    M3 - Journal article

    VL - 72

    SP - 71

    EP - 77

    JO - Journal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)

    JF - Journal of Plastic, Reconstructive & Aesthetic Surgery (Print Edition)

    SN - 1748-6815

    IS - 1

    ER -