First Autologous Cell Therapy of Cerebral Palsy Caused by Hypoxic-Ischemic Brain Damage in a Child after Cardiac Arrest—Individual Treatment with Cord Blood

Each year, thousands of children incur brain damage that results in lifelong sequelae. Therefore, based on experimental evidence, we explored the therapeutic potential of human cord blood, known to contain stem cells, to examine the functional neuroregeneration in a child with cerebral palsy after cardiac arrest. The boy, whose cord blood was stored at birth, was 2.5 years old and normally developed when global ischemic brain damage occurred resulting in a persistent vegetative state. Nine weeks later, he received autologous cord blood (91.7？mL, cryopreserved, mononuclear cells) intravenously. Active rehabilitation (physio- and ergotherapy) was provided daily, follow-up at 2, 5, 12, 24, 30, and 40 months. At 2-months follow-up the boy’s motor control improved, spastic paresis was largely reduced, and eyesight was recovered, as did the electroencephalogram. He smiled when played with, was able to sit and to speak simple words. At 40 months, independent eating, walking in gait trainer, crawling, and moving from prone position to free sitting were possible, and there was significantly improved receptive and expressive speech competence (four-word sentences, 200 words). This remarkable functional neuroregeneration is difficult to explain by intense active rehabilitation alone and suggests that autologous cord blood transplantation may be an additional and causative treatment of pediatric cerebral palsy after brain damage. 1. Introduction Brain injury from cardiac arrest in children results from global cerebral ischemia. The outcome varies with duration of resuscitation. Unfortunately, for those who survive cardiac arrest, brain damage may result in lifelong sequelae, for example, cerebral palsy, for which there is no causative cure at present [1]. Only recently experimental evidence has been produced showing that systemic transplantation of human mononuclear cord blood cells—known to contain stem cells—prevents the development of spastic paresis in a model of perinatal ischemia in rodents [2, 3]. These promising therapeutic effects led us to perform an autologous transplantation of cord blood mononuclear cells in a child with severe cerebral palsy on January 27th, 2009. A brief account of this report has been given elsewhere [4]. 2. Material and Methods 2.1. Medical History A 2.5-year-old boy was admitted to a municipal pediatric intensive care unit presenting unspecific gastrointestinal symptoms, persistent vomiting (40–50 times), and tachycardia (>200？bpm) after antiemetic treatment for three days. Past medical history was otherwise unremarkable, physical