Abstract 1 Clinical and Imaging Outcomes After Allogenic Umbilical Cord Blood Transfusions in a Young Adult with Cerebral Palsy

Abstract Introduction Umbilical cord blood transplant is an emerging promising therapy for cerebral palsy. Here we report a case of a 23-year-old spastic quadriplegic young adult whose motor and cognitive function improved after allogenic umbilical cord blood transfusion. Methods The patient received three times of cord blood transfusion intravenously (2022/2/15, 2022/05/16, 2022/8/15). Each cord blood was 4/6 HLA-matched and contained 10 × 107 total nucleated cells (TNC)/kg. Results The young man was born preterm. Due to motor developmental delay, he began rehabilitation when 1-year-old. His best mobility function was GMFCS III. At the age of 18, there was a rapid decline of his mobility. EEG showed seizure like waves and TRODAT brain scan on 2018/9/28 revealed symmetric mild striatal dopaminergic neuron loss. He was totally ADL dependent and mobility and communication severely restricted due to strong spasticity and rigidity. 3 days after 1st cord blood transfusion, he walked 500 steps (1 km/h) on LOKOMAT with 100% guidance force and 50% body weight supported. In the 16th session (when he also completed the 3rd cord blood transfusion), he walked1000 steps (1.5 km/h) on LOKOMAT with 90% guidance force and 50% body weight supported. Afterward, he regained sufficient motor function to maintain daily training with traditional physiotherapy. There was no adverse event during all the transplant procedures. Brain images taken before and after cord blood transfusion were compared with a brain-age predicting model to obtain differences in predicted and chronological age in 3 sets of brain images. The result showed reduced differences between predicted and chronological brain age (Figure 1). His mother reported that he became more alert and more responsive during interaction. Discussio This case highlights the therapeutic effect of allogenic umbilical cord blood transfusion to benefit adult CP manifest deterioration in physical activity and cognitive function. The specific mechanisms involved in this process are not yet fully understood. Therefore, any use of stem cell transplantation for the treatment of cerebral palsy should be done under the guidance of good clinical practice to accumulate robust real-world data, and more research is needed to fully understand its mechanisms of action.