Allogenic umbilical cord blood therapy combined with erythropoietin for patients with severe traumatic brain injury: Three case reports

Abstract

Objective: To report the safety and efficacy of a novel therapeutic trial with umbilical cord blood (UCB) and concomitant recombinant human erythropoietin (rhEPO), which was tried for three cases of severe traumatic brain injury (TBI) in rehabilitation. Design: Case series. Setting: University hospital setting. Participants: Three patients with TBI over 6-months post-injury. Interventions: Intravascular administration of allogenic UCB and injection of rhEPO, and rehabilitation therapy. Outcomes: For safety, adverse events, symptom, vital signs, blood chemistry, and hematologic study; for efficacy, modified Barthel index, motor assessment scale, Fugl-Meyer assessment of upper extremity, motor-free visual perception test, mini-mental screening examination, and brain images. Results: There were no serious adverse events and the participants showed improvements during the follow-up periods in various aspects. Patient 1 demonstrated improvements in motor and cognitive function. Diffusion tensor images showed increased nerve fibers. Patient 2 displayed improvements in activities of daily living. In Patient 3, neurogenic fever vanished and Brain PET revealed increased glucose metabolism at basal ganglia, thalami, and cerebellum. Conclusions: The allogenic UCB therapy combined with rhEPO in the present study was safe and suggested potential therapeutic efficacy for patients with TBI. Controlled clinical trials are now needed to document efficiacy and safety in a larger patient sample.