Transfusão de células derivadas da fração total de células nucleadas da medula óssea em um canino com trombocitopenia persistente

Abstract

Mesenchymal stem-cells have been studied for therapy of various diseases, by their immunomodulatory, angiogenic properties. This report aims to describe the use of cells derived from the total fraction of bone marrow nucleated cells (BMSCs) in a female dog with prednisone-responsive thrombocytopenia. The patient was admitted at the Veterinary Teaching Hospital (VTH) of the Universidade Federal de Santa Maria (UFSM) and was diagnosed with idiopathic epilepsy. She received phenobarbital 2,5 mg/kg SID. After seven months, the patient returned for control and a severe thrombocytopenia was observed (15,000/µL). Tests for hemoparasites, abdominal ultrasound and bone marrow examination were performed in order to investigate differential diagnosis. Although phenobarbital is associated to blood dyscrasias, the treatment could not be suspended, due to the severity of the epilepsy. Prednisone was added to the treatment (2 mg/kg, SID), and a mild response was seen in platelet count (58,000/µL). In order to decrease prednisone, 2,5 x 106 BMSCs were intravenously injected three times with an interval of 27 and 60 days. A positive effect was observed with a significant increase in platelet count, although this increase remained for 7 to 30 days. It is possible that cell therapy could be beneficial when myelotoxic drugs are used . Therapy with BMSCs is a promising alternative in the treatment of immune-mediated thrombocytopenia (ITP) and we conclude that their use resulted in a transitory increase in platelet counts and, therefore, further studies are needed to determine dosage, number of transfusions. The effects of cell therapy in ITP should be analysed without the interference of other drugs.