Application and prospect of adipose stem cell transplantation in treating lymphedema

Table 2 Adipose-derived stem cell treatment of lymphedema in clinical trials

Year	First author	Study type	Patientnumber,test/control	Edemalocation	Cell type	Cell number	Injection method,location/depth	Follow-up inmoassessment	Results
2016	Toyserkani et al[30]	Pilot study	1/0	Upper limb	Freshly isolated autologous ADSCs plus fat graft	4.07 × 107 plus 10 mL lipoaspirate	Axillary region (8 points)	4 mo In vitro cell characterization (cell count, viability, and surface marker)	Great reduction in symptoms of arm heaviness and tension, reduction in need for compression therapy
								Circumference measurements	Volume reduction in affected arm
								Dual-energy X-ray absorptiometry scans Adverse events	No postoperative complications or adverse events
2017	Toyserkani et al[31]	Pilot study	10/0	Upper limb	Freshly isolated autologous ADSCs plus fat graft	5 × 107 plus 30 mL lipoaspirate	Axilla (8 points)	6 mo In vitro cell characterization (cell count, viability, and surface marker)	A small volume reduction but not significant
								Circumference measurements	Patient-reported outcomes improved significantly over time
								Dual-energy X-ray absorptiometry scans	Half of the patients reduced their use of conservative management
								Patient-reported outcome and safety questionnaire assessment	No noteworthy serious adverse events
2019	Toyserkani et al[32]	Pilot study	10/0	Upper limb	Freshly isolated autologous ADSCs plus fat graft	5 × 107 plus 30 mL lipoaspirate	Axilla (8 points)	12 mo In vitro cell characterization (cell count, viability, and surface marker)	No significant change in volume
								Circumference measurements	Patient-reported outcomes improved significantly over time
								Dual-energy X-ray absorptiometry scans	Five patients reduced their use of conservative management
								Patient-reported outcome and safety questionnaire assessment	Quantitative lymphoscintigraphy showed no improvement on the lymphedema-affected arms
								Lymphoscintigraphy changes	ADRCs were well-tolerated and only minor transient adverse events related to liposuction were noted

ADRCs: Adipose-derived regenerative cells; ADSCs: Adipose-derived stem cells.