Plastic Surgery Research Council
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PSRC 60th Annual Meeting

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Adipose Derived Stem Cell Count is Influenced by Receipt of Chemotherapy in Breast Cancer Patients
Brian Mailey, M.D.1, Jennifer Baker, M.D.1, Ava Hosseini, M.D.1, Zeni Alfonso, Ph.D.2, Paula Strasser, B.S.2, Kevin Hicok, Ph.D.2, Steven R. Cohen, M.D.3, Amanda Gosman, M.D.1, Marek Dobke, M.D., Ph.D.1, Anne M. Wallace, M.D.1.
1UCSD, San Deigo, CA, USA, 2Cytori Therapeutics, San Deigo, CA, USA, 3Faces+, San Deigo, CA, USA.

PURPOSE:
The identification of mesenchymal stem cells (MSC) in adult human fat was first described in 2001. The clinical significance and therapeutic utility of these cells is still unclear. We sought to determine the relationship of MSC to receipt of previous systemic chemotherapy.
METHODS:
All patients undergoing fat grafting to the breast after cancer reconstruction were offered participation in study. Patients were imaged with volumetric three-dimensional stereophotogrammetry preoperative and at selected time-points up to 6-months postoperative. Additional fat harvested in the operating room (mean 64 ± 38 grams) was analyzed for stromal vascular fraction cells per gram (c/g), colony forming units (CFU), percent viability and by flow cytometry for CD45, CD34, CD31 and CD146 markers. Patients were categorized by percent fat retention and by receipt of systemic and hormonal chemotherapy.
RESULTS:
Between September 2012 and July 2013, 28 patients were accrued to study. The average age and BMI of the patients were 54, SD ± 10 years and 27.8, SD ± 5, respectively. Of these, 54% (N=15) previously received chemotherapy and 46% (N=13) did not. The mean cell count, c/g and percent viability for patients who received chemotherapy was higher than those who did not (2.27 x 106 vs. 1.06 x 106, p=0.01; 1.8 x 105 vs. 3.0 x 105, p=0.001; and 88% (SD ± 3.5), and 84% (SD ± 5), p=0.03, respectively). Stratified by timing of chemotherapy, c/g was higher for patients who received chemotherapy in a more distant past (3.1 x 105, vs. 2.8 x 105 vs. 1.8 x 105 for >18 months, ≤18-months and no chemotherapy, respectively, p=0.006).
CONCLUSION:
Receipt of chemotherapy affects number of MSC present in fat. This finding may represent a response of fat-derived MSC to meet physiologic needs. The role these cells contribute to tissue repair and regeneration remains undefined, however their increase after systemic chemotherapy might indicate a rebound effect of the body shifting from a catabolic to an anabolic state.


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