Lymphedema

Breast cancer-related lymphedema is one of the most common and serious late complications following breast cancer surgery with axillary lymph node involvement as up to one-third of patients develop lymphedema (1).  The lymphatic system plays a crucial role in maintaining fluid homeostasis in the arm. Under normal physiologic conditions appr. 10% of the liquid volume from the arm runs  through lymphatic vessels that form an interconnected drainage tube system in tissues. They transport fluid, serum proteins, and lipids from the interstitial spaces back to the circulation. When this system is compromised, the extracellular liquid accumulates in the arm drastically increasing arm volume. Lymphedema is a debilitating condition that results in serous symptoms including pain, fibrosis, recurrent infections and reduced life quality including poor function of the arm and long sick leaves (2). Many patients do not return to the job market.  Breast cancer is the most common cancer in women with 4500 new cases pr. year in DK. Conventional therapy using compression and physiotherapy does not solve the problem, but we have shown that one bolus injection in the affected arm significantly alleviates the condition (3).

1.     B. B. Lasinski et al., A systematic review of the evidence for complete decongestive therapy in the treatment of lymphedema from 2004 to 2011. PM R 4, 580-601 (2012).

2.     N. M. Toyserkani, M. L. Quaade, J. A. Sorensen, Cell-Assisted Lipotransfer: A Systematic Review of Its Efficacy. Aesthetic Plast Surg 40, 309-318 (2016).

3.     N. M. Toyserkani, C. H. Jensen, S. P. Sheikh, J. A. Sorensen, Cell-Assisted Lipotransfer Using Autologous Adipose-Derived Stromal Cells for Alleviation of Breast Cancer-Related Lymphedema. Stem Cells Transl Med 5, 857-859 (2016). 

Treatment:

Our aim is to treat lymphedema, a common and serious life long side effect to cancer treatment. Successful treatment will reduce risk of serious skin infections and reduce forced retirement due to arm dysfunction. In reality no effective treatment for lymphedema exists today. The standard care for lymphedema after mastectomy is lifelong conservative treatment that includes physiotherapy and compression both of which are unsatisfactory (1). Even though microsurgical techniques have shown some success there is a need for better treatment modalities (2). Previously others have shown that cells derived from bone marrow can be used to treat lymphedema (2), but we are the first to report that this can also be achieved using ADRCs (3). Still, cell preparation, dosage and administration route needs to be improved, and randomised clinical trials must be performed to confirm the benefit to the patient. Blue Cell treatment offers a new intervention to reduce lymphedema, enabling patients to return to working life and increase quality of life.