ABSTRACT
Background:Autologous bone marrow stem cell transplantation
without immune suppression has been proposed as a safe and efficient therapeutic option to replace β-cell
mass destroyed by specific antibodies in chronic type 1 diabetes but we have
not scientific information about how long the metabolic stability is
maintained. Material and Method: From 2010 to 2014, were included 134 chronic type 1
diabetics patients (p.) in an autologous bone marrow stem cell transplantation
protocol, stimulated with filgrastim, without immune suppression, c peptide
< 0.5 ng/ml and pancreatic antibodies negatives, without diabetes
complications. 65 Female and 69 Male patients, with 36 + 20 years old and
insulin-dependent were treated. Follow up variables, c peptide, A1C, pancreatic
islets and GAD antibodies and insulin dose at 6, 12, 24 and 36 months were
performed. Results:C peptide, 6 months after transplantation more than 0.9 ng/ml in 61
patients (45%) (P = 0.001, CI = 95%). At 12 months 50 patients (37%) (P =
0.001, CI = 95%). At 24 months 53 patients (39%) (P = 0.001, CI = 95%). At 36
months 51 patients (38%) (P = 0.001, CI = 95%). A1C before transplant, <7%
was observed in 25 p. (18%). At 6 months 68 p. (50%), 12 months 90 p. (67%), 24
months 92 p. (68%), at 36 months in 85 p. (63%) Patients without Insulin dose,
at 6 months 61 p. (45%), 12 months 60 p. (44%), 24 months 58 p. (43%), at 36
months in 53 p. (39%). No evidence of new pancreatic antibodies or adverse
events. Conclusion:Autologous bone marrow stem cell transplantation, without immunosuppression,
improves pancreatic function and metabolic control without new immune reaction
after three years of follow up in chronic type 1 diabetic patients.