Familial occurrence of pulmonary embolism after intravenous, adipose tissue-derived stem cell therapy

Abstract

The therapeutic potential of human multipotent mesenchymal stromal cells, especially human adipose tissue-derived stem cells (hASC), is promising. However, there are concerns about the safety of infusion of hASC in human. Recently, we have experienced pulmonary embolism and infarct among family members who have taken multiple infusions of intravenous autologous hASC therapy. A 41-year-old man presented with chest pain for one month. Chest CT showed multiple pulmonary artery embolism and infarct at right lung. Serum D-dimer was 0.8 μg/mL (normal; 0-0.5 μg/mL). He had received intravenous autologous adipose tissue-derived stem cell therapy for cervical herniated intervertebral disc three times (one, two, and three months prior to the visit). His parents also received the same therapy five times and their chest CT also showed multiple pulmonary embolism. These cases represent artificial pulmonary embolisms and infarct after IV injection of hASC. Follow-up chest CT showed spontaneous resolution of lesions in all three patients.

Keywords: Stem cell; family; infarct; pulmonary embolism.

Fig. 1

Chest CT of patient. (A) Chest CT demonstrates wedge-shaped, peripheral consolidation at upper lobe of right lung (black arrow), which is consistent with pulmonary infarct. (B) Chest CT shows multiple filling defects (white arrows) at segmental pulmonary artery branches of right lung along with right pleural effusion (black arrow head). (C) Follow-up chest CT taken three month later showed disappearance of pleural effusion and pulmonary emboli.

Fig. 2

Chest CT of his father (A) revealed multiple emboli at segmental pulmonary artery branch (white arrow head) and right pleural effusion (white arrow). Chest CT of his mother (B) showed linear emboli (white arrow) along the lumen of pulmonary artery branch of right lung.