Long Term Benefit of Autologous Bone Marrow Stem Cell Transplantation without Immunosuppression in Chronic Type 1 Diabetic Patients

Background: Autologous bone marrow stem cell transplantation without immune suppression has been proposed as a safe and efficient therapeutic option to replace β-cell mass destroyed by specific antibodies in chronic type 1 diabetes but we have not scientific information about how long the metabolic stability is maintained.Material and Method: From 2010 to 2014, were included 134 chronic type 1 diabetics patients (p.) in an autologous bone marrow stem cell transplantation protocol, stimulated with filgrastim, without immune suppression, c peptide < 0.5 ng/ml and pancreatic antibodies negatives, without diabetes complications.65 Female and 69 Male patients, with 36 + 20 years old and insulin-dependent were treated.Follow up variables, c peptide, A1C, pancreatic islets and GAD antibodies and insulin dose at 6, 12, 24 and 36 months were performed.Results: C peptide, 6 months after transplantation more than 0.9 ng/ml in 61 patients (45%) (P = 0.001, CI = 95%).At 12 months 50 patients (37%) (P = 0.001, CI = 95%).At 24 months 53 patients (39%) (P = 0.001, CI = 95%).At 36 months 51 patients (38%) (P = 0.001, CI = 95%).A1C before transplant, <7% was observed in 25 p. (18%).At 6 months 68 p. (50%), 12 months 90 p. (67%), 24 months 92 p. (68%), at 36 months in 85 p. (63%) Patients without Insulin dose, at 6 months 61 p. (45%), 12 months 60 p. (44%), 24 months 58 p. (43%), at 36 months in 53 p. (39%).No evidence of new pancreatic antibodies or adverse events.Conclusion: Autologous bone marrow stem cell transplantation, without immunosuppression, improves pancreatic function and metabolic control without new immune reaction after three years of follow up in chronic type 1 diabetic patients.