Autologous Umbilical Cord Blood Transfusion in Very Young Children With Type 1 Diabetes
Article Figures & Tables
Figures
- Figure 1
Autologous cord blood infusion in type 1 diabetes: study timeline. Our study was designed as a 2-year observational study of the effects of autologous cord blood infusion in children with type 1 diabetes. Each child was followed every 3 months during the first year postinfusion and every 6 months during the second year postinfusion. Blood was obtained for metabolic and immunologic studies at each visit. Mean time from type 1 diabetes diagnosis to umbilical cord blood infusion was 6 months. Herein, we report 1 year postinfusion data on the first 15 umbilical cord blood recipients to reach 1 year of post–cord blood infusion follow-up. T1D, type 1 diabetes; UCB, umbilical cord blood; q, every.
- Figure 2
Insulin use (A) and A1C (B) in umbilical cord blood recipients and historical control subjects over 1 year. Data are medians with error bars showing IQRs and are presented for the sake of comparison with clinical expectations. Because the average time from diagnosis to umbilical cord blood infusion was 6 months, comparisons correlate with 6, 12, and 18 months post–type 1 diabetes diagnosis in both umbilical cord blood recipients and historical control subjects. Whereas the absolute value of A1C and insulin requirement in umbilical cord blood recipients was lower than that in control subjects at baseline, 6 months, and 12 months, the relevant statistical comparison of percent change was no different over time (Table 2).
Tables
- Table 1
Baseline and 1-year postinfusion characteristics of autologous umbilical cord blood recipients (n = 8 male and 7 female)
Preinfusion 1-year postinfusion (Preinfusion-to–1 year postinfusion ratio) −1 P vs. baseline Age (years) 5.5 (3.1–7.3) — — — Time from diagnosis to infusion (months) 4.1 (2.5–7.1) — — — A1C (%) 7.0 (6.1–8.3) (15) 7.0 (6.5–7.7) (15) 0.035 (−0.07 to 0.125) (15) 0.45 Insulin use (units · kg−1 · day−1) 0.42 (0.21–0.55) (15) 0.67 (0.55–0.77) (15) 0.52 (0.00–1.56) (15) 0.0085 Peak C-peptide (ng/ml) 0.93 (0.7–2.03) (14) 0.50 (0.26–1.30) (12) −0.53 (−0.72 to −0.32) (12) 0.0024 IA-2 9.5 (1.8–20.6) (11) 9.8 (0.7–14.47) (9) −0.48 (−0.58 to −0.10) (8) 0.20 GAD 4.2 (0.9–11.4) (13) 3.5 (0.45–33.5) (12) −0.44 (−0.63 to 0.34) (11) 0.52 WBC (cell × 109/l) 5.5 (4.9–7.3) (14) 4.9 (4.2–6.3) (14) −0.13 (−0.29 to 0.14) (14) 0.031 CD4-to-CD8 ratio 2.0 (1.7–2.6) (14) 1.9 (1.6–2.2) (12) −0.03 (−0.13 to 0.11) (12) 0.86 Peripheral blood Treg (%) 5.4 (2.4–7.0) (12) 5.0 (4.1–7.2) (13) 0.31 (−0.06 to 2.00) (11) 0.12 Data are median (IQR) (n). IA-2, insulinoma-associated protein 2 autoantibody; WBC, white blood cell count.
- Table 2
Historical control subjects (n = 30)
6 months postdiagnosis 18 months postdiagnosis (Baseline-to–1 year ratio) −1 Median (IQR) P Median (IQR) Median (IQR) P A1C (%) 7.6 (6.6–8.2) 0.16 7.8 (7.3–8.5) 0.040 (−0.076 to 0.146) 0.73 Insulin use (units · kg−1 · day−1) 0.56 (0.50–0.67) 0.011 0.77 (0.68 to 0.85) 0.41 (0.15–0.59) 0.50 Comparisons were made using 6 months and 18 months postdiagnosis time points because these correlated with average time from diagnosis to infusion and average time from diagnosis to 1 year postinfusion in the umbilical cord blood recipients. P values are by two-sided Wilcoxon tests vs. umbilical cord blood recipients. See Table 1 for descriptive statistics for umbilical cord blood recipients.
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