You are hereJune 23, 2016
Stem Cell Injections Help Woman with Lymphedema Caused by Cancer Treatment
DURHAM, NC - In a new case report published today in STEM CELLS Translational Medicine, doctors at Odense University Hospital in Denmark detail how a patient who developed lymphedema after being treated for breast cancer benefitted from an injection of stem cells derived from adipose (fat) tissue. The results could change the paradigm for dealing with this debilitating, frequent side effect of cancer treatment.
Lymphedema refers to the swelling that generally occurs in an arm or leg – or both – after lymph nodes have either been surgically removed (lymphadenectomy) or damaged by radiation during cancer treatment, particularly for breast cancer. Some patients’ bodies are able to accommodate for the missing or damaged nodes, but in others this causes a blockage in the lymphatic system, which in turn leads to a buildup of waste and fluid.
Along with cosmetic issues, in severe cases, lymphedema causes pain and limits movement. It also can have more serious complications, such as infections of the skin or lymph vessels. The smallest injury to the patient’s arm or leg can be an entry point for infection – or a rare form of soft tissue cancer called lymphangiosarcoma.
There is no cure for lymphedema; relief comes mainly from compression therapy, but this depends on continuous adherence to be effective and even then it doesn’t always produce adequate results.
“Stem cell therapy has the potential to change the treatment paradigm from a conservative to a more curative approach,” said Navid Mohamadpour Toyserkani, M.D., of Odense University Hospital’s Department of Plastic and Reconstructive Surgery and the study’s first author. “Accordingly,” added the study’s senior author, Jens Ahm Sørensen, Ph.D., “new therapeutic approaches are needed to treat this condition. One such approach is stem cell therapy.”
After reviewing all the existing studies in which stem cells were used to treat lymphedema, the authors found that each employed bone marrow-derived mesenchymal stem cells (MSCs). “Adipose (fat) tissue is the most abundant and easily accessible source of MSCs, but it had not been used yet for lymphedema treatment, so we decided to see how that would work,” Dr. Toyserkani said. “To our knowledge, we are the first to report on this.”
The team used liposuction to collect adipose-derived stromal cells from a 48-year-old woman with breast cancer-related lymphedema of her arm due to lymphadenectomy and radiation therapy four years previously. They combined the cells with a fat-graft procedure and injected them at eight different points into her armpit area. Four months later, she showed great improvement in her daily symptoms, a reduced need for compression therapy and a reduction in the size of her arm. There were no adverse events.
“We still have questions that need to be answered – for example, potential changes in lymph drainage were not assessed, so we cannot conclude that cell therapy helped this,” Dr. Sørensen said. “But the outcome of this patient provides a foundation for the potential use of cellular therapy for lymphedema treatment.”
“Based on the promising preclinical and clinical results,” Dr. Toyserkani added, “we have initiated a larger, phase II study in our department to further test the feasibility and safety of this procedure.”
“The treatment of lymphedema is a significant challenge in breast cancer surgery,” said Anthony Atala, M.D., Editor-in-Chief of STEM CELLS Translational Medicine and Director of the Wake Forest Institute for Regenerative Medicine. “The positive results from this patient, combined with results of previous studies using bone marrow-derived stem cells, suggests the potential of cellular therapy for treating lymphedema.”
The full article, “Cell-assisted lipotransfer using autologous adipose-derived stromal cells for alleviation of breast cancer-related lymphedema,” can be accessed at http://stemcellstm.alphamedpress.org/content/early/2016/05/03/sctm.2015-0357.abstract.