Human chromaffin cell graft into the CSF for cancer pain management: A prospective phase II clinical study

Yves Lazorthes, Jacqueline Sagen, Brigitte Sallerin, Jean Tkaczuk, Hélène Duplan, Jean Christophe Sol, Mathieu Tafani, Jean Claude Bès

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

A number of pre-clinical studies have demonstrated the value of adrenal medullary allografts in the management of chronic pain. The present longitudinal survey studied 15 patients transplanted for intractable cancer pain after failure of systemic opioids due to the persistence of undesirable side-effects. Before inclusion, all the patients had their pain controlled by daily intrathecal (I-Th) morphine administration. The main evaluation criteria of analgesic activity of the chromaffin cell allograft was the complementary requirement of analgesics and in particular the consumption of I-Th morphine required to maintain effective pain control. Out of the 12 patients who profited from enhanced analgesia with long-term follow-up (average 4.5 months), five no longer required the I-Th morphine (with prolonged interruption of systemic opioids as well), two durably decreased I-Th morphine intake and five were stabilized until the end of their follow-up. Durable decline and stabilization were interpreted as indicative of analgesic activity by comparison with the usual dose escalation observed during disease progression. In most cases, we noted a relationship between analgesic responses and CSF met-enkephalin levels. The results of this phase II open study demonstrate the feasibility and the safety of this approach using chromaffin cell grafts for long-term relief of intractable cancer pain. However, while analgesic efficacy was indicated by the reduction or stabilization in complementary opioid intake, these observations will need to be confirmed in a controlled trial in a larger series of patients. Copyright (C) 2000 International Association for the Study of Pain. Published by Elsevier Science B.V. All rights reserved.

Original languageEnglish (US)
Pages (from-to)19-32
Number of pages14
JournalPain
Volume87
Issue number1
DOIs
StatePublished - Jul 1 2000

Keywords

  • Allograft
  • Cancer pain
  • Chromaffin cell
  • Intrathecal morphine
  • Met-enkephalin

ASJC Scopus subject areas

  • Clinical Neurology
  • Psychiatry and Mental health
  • Neurology
  • Neuroscience(all)
  • Pharmacology
  • Clinical Psychology

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    Lazorthes, Y., Sagen, J., Sallerin, B., Tkaczuk, J., Duplan, H., Sol, J. C., Tafani, M., & Bès, J. C. (2000). Human chromaffin cell graft into the CSF for cancer pain management: A prospective phase II clinical study. Pain, 87(1), 19-32. https://doi.org/10.1016/S0304-3959(00)00263-3