Adipose-derived regenerative cells and fat grafting for treating breast cancer-related lymphedema: Lymphoscintigraphic evaluation with one year follow-up

Publication date: Available online 20 September 2018

Source: Journal of Plastic, Reconstructive & Aesthetic Surgery

Author(s): NM Toyserkani, CH Jensen, S Tabatabaeifar, MG Jørgensen, S Hvidsten, JA Simonsen, DC Andersen, SP Sheikh, JA Sørensen

Abstract

Background: Breast cancer-related lymphedema (BCRL) is a feared late complication. Present treatment options are lacking. Recent studies have suggested that mesenchymal stromal cells can alleviate lymphedema. Herein, we report the results from the first human pilot study with adipose-derived regenerative cells (ADRC) for treating BCRL with one year follow-up. Material and methods: We included ten BCRL patients. ADRCs were injected directly into the axillary region together with a scar releasing fat graft procedure. Primary endpoint was change in arm volume. Secondary endpoints were change in patient reported outcome, lymphoscintigraphy changes and safety. Results: During follow up, no significant change in volume was noted. Patient reported outcomes improved significantly over time. Five patients reduced their use of conservative management. Quantitative lymphoscintigraphy did not improve on the lymphedema affected arms. ADRCs were well-tolerated and only minor transient adverse events related to liposuction were noted. Conclusions: In this pilot study, a single injection of ADRC improved lymphedema based on patient reported outcome measures and there were no serious adverse events in the follow-up period. Lymphoscintigraphic evaluation showed no improvement after ADRC treatment. There was no change in excess arm volume. Results of this trial need to be confirmed in randomized clinical trials.