Rehab Science Blog » Lymphedema » Stem Cell Therapy for Lymphedema: Has the Future Arrived?

Stem Cell Therapy for Lymphedema: Has the Future Arrived?

By: Ryan Davey, PhD  
January 16, 2018
Editors: Ryan Davey, PhD and Lindsay Davey, MScPT, MSc, CDT

Could stem cell therapy be used to treat the chronic swelling condition known as lymphedema? Early clinical trials offer us a glimpse into the future: lymphedema stem cell therapy for the repair and regrowth of damaged lymphatics.

When I entered the field of stem cell research as a graduate student in 2001, the term “stem cell” was virtually unheard of. Not anymore, thanks to an abundance of headline-worthy advances making the news on a regular basis. The concept is thrilling: have a non-functioning body part? Regrow it using a special cell type that holds the potential for nearly unlimited growth and repair: the stem cell.

While most would agree that science is still a very long way from being able to regrow a heart or other complex structure, researchers in academia and industry are scrambling to identify conditions that might be treatable today, using current stem cell technology. What might these potentially treatable conditions look like? Could lymphedema be a good candidate?

To be a good candidate for stem cell therapy, the defective structure needing repair would ideally be:

  1. Comprised of a single or small number of different cell types – because promoting the development of multiple types of cells with appropriate coordination between them is a big challenge.
  2. Small in size – because larger structures are harder to grow and introduce additional complexities including the need for blood vessels to allow for gas, nutrient and waste exchange.
  3. Simple in organization – because encouraging developing cells and tissues to arrange into a three-dimensional structure that functions as a whole is a huge challenge.

Could lymphedema fit the bill as an early target for stem cell therapy? Some researchers believe so. I am aware of three early stage clinical trials published to date that investigate stem cells therapies for treating breast cancer related lymphedema: one was published in 2008, one in 2011, and one completed and published in 2017. Here’s how the authors of this latest Phase II clinical trial summarize the results of their study (ref 1):

“Treatment with autologous adipose-derived regenerative cells [in other words, stem cells] can alleviate symptoms and reduce the need for other treatment options during the 6 months follow-up. The treatment proved safe without any noteworthy adverse events. Randomized controlled trials will be needed to verify the positive results.”

Sounds exciting! Let’s dig into this latest study to answer the key question: should lymphedema patients be excited about a near-term stem cell treatment (or cure) for lymphedema? Here’s what the researchers did and what it means for lymphedema patients:

I) The researchers’ hypothesis is reasonable: alleviate lymphedema not cure it

Regenerative medicine will hopefully one day offer a cure for lymphedema, but the first step down that path will be to try to use stem cell therapy to alleviate some of the symptoms of lymphedema. This is a logical starting point, and curing lymphedema with stem cell therapy is going to be a LOT harder, as I will explain a bit further below.

Treating some of the symptoms of Lymphedema with stem cell therapy is a near-term possibility

In my opinion, the likelihood of a “near-term” stem cell or pharmaceutical treatment to help reduce the symptoms of lymphedema is high. But I put quotations around “near-term” because:

  1. It can take a LONG time to convert successful clinical trials into a widely available medical treatment, and cell-based therapies can present much greater regulatory, logistical and financial hurdles than typical run-of-the-mill pharmaceuticals. In a nut shell: it can be expensive and difficult to isolate and utilize living cells in medicine, and using living stem cells might introduce an unacceptable risk of cancer. On the flip side, in some cases it appears that proteins and other factors released by stem cells into their environment may be just as effective as the cells themselves in treating some injuries. Identifying, manufacturing, and using these factors instead of the cells themselves may more closely align with the potentially simpler pharmaceutical regulatory model.
  2. My optimistic “near-term” statement needs to be tempered by two other unfortunate realities of the world we live in: (1) Developing treatments for conditions like lymphedema requires significant research funding, and funding needs grow as the technology approaches commercialization. (2) Even if treatments are found that appear ready for commercialization, there may be insufficient incentive for a commercial company to undertake the enormous task (and expense) of bringing the novel treatment to fruition and then to market.

Why do I think the possibility of a novel treatment for lymphedema symptoms is high? Lymphedema is a progressive condition if not managed; the symptoms gradually worsen with time as the initial lymphatic deficiency contributes to ongoing cumulative damage to still-functional neighbouring lymphatics. Repairing the initial damage or dysfunction will be very difficult, but preventing and repairing on-going damage to healthy lymphatic vessels is relatively low hanging fruit. Natural repair processes in the body are already at work in these patients, but this repair process appears to eventually stall out, apparently due in part to inhibitory inflammatory processes (ref 2). Enhancing the normal repair process by supplementing the body with stem cells therapy (or the protein factors secreted by stem cells – see more on this below) is a promising strategy. In fact, there is a related lymphedema drug candidate called Ubenimex which appears to target this negative inflammatory process that is already undergoing a clinical trial.

Curing lymphedema with stem cell therapy is still far off

In my opinion, the likelihood of a “near-term” regenerative medicine (stem cell) or pharmaceutical cure for lymphedema is very low.

Why do I think a stem cell cure for lymphedema is still far off? Lymphedema is caused by a significant loss, damage or abnormal function of lymph nodes and vessels. These nodes and vessels make up an intricate and extensive fluid transport and immune surveillance system. Smaller lymph capillaries and vessels actively drain excess fluid from tissues, which in turn transport the fluid into larger collecting lymph vessels at lymph nodes on its way back to joining the blood circulatory system at the heart. The body is robust and the lymphatic system has excess fluid handling capacity, so significant dysfunction or disruption of this system is required before lymphedema onset occurs. Unfortunately, this means that if you do have lymphedema symptoms, then you likely have a significant level of damage, and so curing it will also require significant repair/regeneration.

Many of the best opportunities for stem cell therapy today lie in enhancing or supplementing the body’s own natural repair and regeneration processes. Unfortunately, the body’s natural repair processes appear to be unable to regenerate lymph nodes. If the body can’t normally muster a good attempt at re-growing or repairing a certain damaged structure, it’s likely that it will also fail one or more of my three criteria above for a (potentially) stem cell-treatable condition using today’s technology. Indeed, functional lymph node regeneration using current stem cell therapy techniques does not currently appear feasible because:

  1. Lymph nodes are relatively large structures. Yes, lymph nodes can be very small (a few centimeters down to a few millimeters in size), but not so small as to not require blood vascularization for survival (ref 3).
  2. Lymph nodes have a relatively complex three-dimensional structure and are comprised of multiple different cell types. Lymph nodes are comprised of multiple cell types and connective tissue, and they need to be properly arranged and connected to smaller lymphatic vessels coming in (“afferent lymph vessels”) and larger ones going out (“efferent lymph vessels”). Not an easy task. See Figure 1.
Lymph node structure suggests lymphedema stem cell therapy may be challenging

Figure 1: The relatively complex structure of a lymph node. Image courtesy of https://en.wikipedia.org/wiki/Lymph_node.

 

Lymph nodes and vessels are formed during embryogenesis (around the sixth week of fetal development) and integrate into the blood circulatory system as it develops. Perhaps not surprisingly then, using stem cell therapy to regrow functional lymph nodes that are appropriately integrated with lymphatic and blood vessels goes beyond our bodies’ natural healing capabilities, and our current scientific understanding.

Contrast the lymphatic system with one of the trendiest targets for stem cell therapy: the eye. Repairing various eye conditions will require relatively small types and numbers of cells, and with simple structural organization. The eye has numerous other advantages that make it an attractive target, such as the relative ease of growing the relevant cell types, surgical simplicity of the eye, reduced possibility for immune rejection, good animal models, ability to easily compare treatment effects to the other untreated eye, etc. (ref 4). Nevertheless, to my knowledge there are still no stem cell therapies for the eye approved in Canada or the US. This should give us some pause when contemplating the likelihood of near-term stem cell therapies for lymphedema.

II) The researchers chose a great stem cell type to test

The authors of this latest lymphedema stem cell therapy trial chose a very popular stem cell type that’s filled with promise: mesenchymal stem cells. This type of stem cell is known to be able to generate a wide variety of different cell types including lymphatic endothelial cells (ref 5), as well as secrete many protein factors that influence vascular repair and inflammation processes (such as ‘VEGF’). It also offers reduced risk of tumour formation compared to some other stem cell types. The two previous lymphedema stem cell therapy clinical trials also used this type of cell, collected from the patient’s own bone marrow (ref 6,7). Building on this previous work, this latest clinical trial harvested a source of mesenchymal stem cells found in adipose tissue (fat), which is both abundant and easily collected, and shows few complications at the donor site.

There is a lot of excitement about mesenchymal stem cells. At the time of writing this there are currently 364 active mesenchymal stem cell trials registered in the National Institute of Health clinical trials database, 299 of which fall into Phase I (186) or Phase II trials (113), 19 in Phase III, and two trials that are in Phase IV. A 2015 review of mesenchymal stem cell clinical trials found that about 89% were Phase 1 or 2, which was found to be similar to 2011 (ref 4), and this is not far off from the 84% we see today. This suggests that we are in much the same position today as we were 6 years ago, with many early clinical trials on-going, but unfortunately not many progressing down the clinical trial pipeline towards regulatory approval.

Why might this be? The simple answer is there is still a lot left to be known about stem cells, even when we are dealing with mesenchymal stem cells derived from well-known sources in adults, and used to treat those same adults (‘autologous transplantation’). It’s not even clear if the beneficial effects observed in stem cell therapy trials arise from the cells themselves (by them generating the needed cell types and thus regrowing/repairing the damaged tissue directly) or from the protein factors they secrete. Many researchers favour the latter hypothesis. A recent study of these same adipose-derived mesenchymal stem cells in advanced diabetic neuropathy (ref 8) found that the positive effects of stem cell transplantation could be replicated by injecting only what the stem cells secreted rather than the stem cells themselves (which incidentally is a much safer approach from a tumor-risk perspective).

We should also keep in mind that just because someone is running clinical trials doesn’t mean that a clinical trial is a good idea. There are scientifically questionable clinical trials performed all the time, including in the field of stem cell therapy. For example, one recent review identified a stem cell clinical trial where the stem cell being investigated was not known to regenerate an appropriate cell type for the condition being treated, and another that raised grave safety and ethical concerns (ref 4).

III) The researchers’ clinical trial was poorly designed

Drawing conclusions from the recent lymphedema stem cell therapy trial is unfortunately significantly hampered by the poor experimental design of the study.

Here are some requirements of a good clinical trial for lymphedema stem cell therapy:

  1. Trial focuses on objective outcome measures – in other words physical measurements rather than a patient’s subjective experience of how well a treatment worked. Patients want the therapy to work, and the ‘placebo effect’ is both very real and very powerful.
  2. Trial controls for bias and the placebo effect – both the experimenter and the patient should be unaware (or ‘blind’) to who has received the actual treatment vs a pretend (‘sham’) treatment.
  3. Trial demonstrates a mechanism of action for any positive effects observed – if a patient’s condition appears to improve in response to treatment, the targeted tissue should be different on a cellular level – and ideally the stem cells should be present and integrated into the tissue.

This latest clinical trial did not pass any of these three criteria. They did try collect objective outcome measurements (in this case arm volume measurements), but they were unable to show any difference between treated and untreated patients, and so instead drew their study conclusions based on how the patients reported they felt about their treatment.

Calling the clinical trial ‘poorly designed’ isn’t an attack on the researchers or their capabilities, the design flaws are instead a reflection of the cost and difficulty of running a clinical trial in the real world. In fact, this same group wrote a review paper in 2014 pointing out the very same flaws in the previous lymphedema stem cell therapy trials (ref 9).

This current trial also suffers from one other significant design concern – the stem cells were delivered to the patients as part of a scar-releasing fat grafting procedure. I don’t know the details of the procedure they performed, but I do know that there is a chance that fat grafting alone may provide benefit to lymphedema patients. In fact, I found an active clinical trial that’s exploring the possible safety and effectiveness of using fat grafting to treat breast cancer related lymphedema (ClinicalTrials.gov NCT02981485).

IV) The results of the stem cell therapy trial doesn’t tell us enough

The researchers performed an interesting trial and interpreted their results with optimism, but they correctly caution that their results need to be confirmed “in a properly blinded randomized controlled trial” and further investigation is required to confirm that any potential “beneficial effect is caused by the ADRC [stem cell] or the fat graft alone, or a combination” (ref 1). The two previous lymphedema stem cell therapy studies also showed promise, but likewise due to poor design fail to add much to the discussion of the possible effectiveness of stem cell therapy for lymphedema (ref 6,7).

It is also important to point out that Phase II studies typically need to show a very strong and clear benefit, because larger and more involved Phase III and IV studies typically include a greater variety of patients and disease-states, which can make small benefits found in early clinical trials disappear.

V) Stem cell therapy for lymphedema: the path forward

Patients with lymphedema should feel heartened that bold studies such as these are being performed. The knowledge gained will one day contribute to better treatments for lymphedema symptoms and perhaps eventually a cure for the condition. But the path leading from where we are to where we want to be is still uncertain, with many roadblocks ahead.

I remain optimistic. I will admit that if you look closely (and critically) at any one stream of research in isolation it might feel a bit discouraging, but research can and does make unanticipated leaps when multiple lines of investigation are combined, and there is certainly fertile ground developing for just such a leap in lymphedema treatment. Clinical research into microsurgical, pharmaceutical and stem cell therapies for lymphedema are all exciting and encouraging – and converging. Combine this with our growing understanding of lymphedema pathogenesis and lymphatic development, and it’s clear that both optimism and further funding are warranted.

References

  1. Toyserkani NM, Jensen CH, Anderson DC, et al. Treatment of Breast Cancer-Related Lymphedema with Adipose-Derived Regenerative Cells and Fat Grafts: A Feasibility and Safety Study. Stem cells Transl Med. 2017 Aug 6(8):1666-1672.
  2. Tian W, Rockson SG, Jiang X, Kim J, et al. Leukotriene B4 antagonism ameliorates experimental lymphedema. Sci Transl Med. 2017 May 10;9(389).
  3. Cornelissen AJ, Qiu SS, Lopez Penha T, et al. Outcomes of vascularized versus non vascularized lymph node transplant in animal models for lymphedema. Review of the literature. J Surg Oncol. 2017 Jan 115(1):32-36.
  4. Trounson A, McDonald C. Stem Cell Therapies in Clinical Trials: Progress and Challenges. Cell Stem Cell. 2015 Jul 2;17(1):11-22.
  5. Buttler K, Badar M, Seiffart V, et al. De novo hem- and lymphangiogenesis by endothelial progenitor and mesenchymal stem cells in immunocompetent mice. Cell Mol Life Sci. 2014 71:1513-27.
  6. Maldonado GEM, Perez CAA, Covarrubias EEA, et al. Autologous stem cells for the treatment of post–mastectomy lymphedema: a pilot study. Cytotherapy. 2011 13:1249-55.
  7. Hou C, Wu X, Jin X. Autologous bone marrow stromal cells transplantation for the treatment of secondary arm lymphedema: a prospective controlled study in patients with breast cancer related lymphedema. Jpn J Clin Oncol. 2008 38:670-4.
  8. Brini AT, Amodeo G, Fereira LM, et al. Therapeutic effect of human adipose-derived stem cells and their secretome in experimental diabetic pain. Sci Rep. 2017 7:9904.
  9. Toyserkani NM, Christensen ML, Sheikh SP, et al. Stem cells show promising results for lymphoedema treatment – A literature review. J Plast Surg Hand Surg. 2015 Apr 49(2):65-71.

No Comments

  1. Linda Shannon Linda Shannon says:

    Thanks for the excellent article on Stem Cell research to grow lymph nodes. Hopefully, soon there will be enough information to offer stem cell replacement to people suffering from secondary lymphedema.

  2. cindy anderson cindy anderson says:

    Done successfully in Cuba in 2010 I believe… see -www.bvs.sld.cu/revistas/hih/vol26_4_10/hih11410.htm

  3. Ryan Davey Ryan Davey says:

    Thanks for passing this along Cindy, and for pleasantly distracting me from what was supposed to be a productive morning ;) The study is very interesting, but unfortunately in my opinion no meaningful conclusions can be drawn from it for a variety of reasons, some being: not a peer-reviewed publication, methods and results are not well described, the patient was atypical – diagnosis of bilateral leg lymphedema of unknown etiology at age 58, had been present for only two years, had suffered previous bouts of lymphatic inflammation (lymphatic filariasis? another infection?), swelling didn’t appear to be responsive to bandaging therapy (after only two years of episodic swelling? why? performed correctly? for how long?), and injection of an unknown number of stem cells into one of the two legs improved the outcome in BOTH legs at six months, AND the improvement started in the feet within a week? What biological mechanism could explain these observations? Perhaps the infection/lymphatic inflammation is episodic and it relieved on it’s own? Perhaps the use of elastic stockings and better care following stem cell treatment compared to the failed attempt prior to treatment – where they apparently didn’t include elastic stockings (which have a much higher patient adherence rate and are easier to apply correctly)…

  4. cindy anderson cindy anderson says:

    Yes, the part about both legs improving though only one had been treated left me wondering as well. I do hope that more progress can be made! Sorry for the distraction!

  5. Ryan Davey Ryan Davey says:

    I hope as well :) Thanks for the distraction.

  6. Jessica Jessica says:

    Thank you for writing this review. It’s well-written and I appreciate the realistic perspective that your expertise can provide. It’s easy as someone living with primary lymphedema to get excited about this progress, but it’s helpful to review such news through a professional’s lens. I can only hope that research continues and we can improve symptoms in primary lymphedema one day, too.

  7. Ryan Davey Ryan Davey says:

    Thanks so much Jessica. The research will definitely continue, and there is reason to feel hopeful that new treatments are on the horizon.

  8. Carl Carter Carl Carter says:

    My 49 yr. old daughter developed lymphedema secondary to cervical cancer surgery with lymph node removal in 2004 No one warned her or instructed her in prevention. In 2009 she was diagnosed by a podiatrist and struggled ever since. She has recently consulted with Dr. Young Ki Shim and is considering going to So . Korea for SQD Drain Procedure and Stem Cell Transplant operation. Are you aware of this Yonsel Hosp. in Seoul? Is there any similar program here in the USA. We would welcome any input you might provide us in combating this debilitating condition.

  9. João Paulo João Paulo says:

    Hi, Davey.
    Is that possible steam cells (not cure, but) reduce definitely the symptomes of it?

    Does it already has this kind o treatment in Canada?

    Thank you.

    best regards.

  10. Ryan Davey Ryan Davey says:

    Hi Joao,

    Unfortunately, there is no stem cell treatment for lymphedema yet (either as a cure or treatment), nor is it clear that there will be one anytime soon. Nevertheless this is an important area of research that might one day contribute to a treatment.

  11. James Penuel James Penuel says:

    My daughter was diagnosed with unilateral primary lymphedema involving her left leg about 15 years ago as a teenager. A recent study from Egypt appears to be a well-designed trial involving 40 patients with primary lymphedema.

    Ahmed Mohammed Ismail, et al, Stem Cell Therapy Using Bone Marrow-Derived Mononuclear Cells in Treatment of Lower Limb Lymphedema: A Randomized Controlled Clinical Trial, LYMPHATIC RESEARCH AND BIOLOGY, Volume 16, Number 3, 2018, 270-277, DOI: 10.1089/lrb.2017.0027

    The trial was not blinded, but objective measurements showed what appeared to be significant beneficial effects on the patients who underwent treatment. The evaluation also included biopsies pre and post therapy that showed evidence of lymphangiogenesis.
    The study also used G-CSF to stimulate the bone marrow prior to aspiration. The G-CSF may have had a beneficial effect as well. It is not clear whether the manipulation of the bone marrow aspirate would be permitted under current FDA guidelines.
    The study appears promising and certainly raises a lot of interesting questions.
    Is there anyone in the US doing any similar treatment?

  12. Ryan Davey, PhD Ryan Davey, PhD says:

    Hi James,

    Thanks for bringing up this study, and for your interesting discussion. I am not aware of anyone in the US doing similar clinical trials right now.

    I just read the paper. I wish I could report that I’m feeling optimistic about it, but to be honest I’m feeling rather skeptical. I don’t mean to disparage the work, because it’s great that researchers are working in this space, but there are a number of significant red flags in this study for me: 1. They said that they collected measurements at the one year mark post-treatment but only showed data up to 6 months. If the 1 year data had looked good they would have of definitely included it. 2. They did not state that their immunohistochemical analysis (where they looked for evidence of lymphangiogenesis) was ‘blinded’. Blinding is necessary to ensure that the person interpreting the biopsies doesn’t know which sample is from before treatment and which is from after treatment. This type of analysis is VERY easily biased if the assessor isn’t blinded. 3. They have at least two significant errors in their data tables: control and treatment group labels are switched for pain and sense of heaviness scores (either that or they completely misinterpreted their data); and they have an impossibly small measurement included in their circumferential measurements table. 4. It’s not clear that treatment and control groups received the same compression therapy. It’s hard to tell for sure because the language they used was vague and unclear, but it seems like perhaps they didn’t. This alone could explain the alleged improvement in circumferential measurement in the treatment vs control groups. 5. The study size was small as was the alleged observed improvement, and most definitely needs to be repeated. 6. From a physiology perspective I see little reason to expect that this type of stem cell therapy would be beneficial for primary lymphedema in the first place. 6. The literature review they chose to include, how they interpreted it, and how they described their study strongly indicates that they were heavily biased towards believing that this type of therapy would work. I could go on…

  13. Josh Josh says:

    Dr Davey,
    I live in Texas and recently attended a seminar about Stem Cell Therapy, primarily for knee cartilage regeneration using Human Umbilical Cord Stem Cells. I am bone on bone in both knees and looking for nonsurgical relief. During my consultation I revealed to the Doctor that I have Primary Lymphadema in both legs.

    The Doctor suggested intravenous injection of Stem Cells to treat the lymphedema in addition to Stem Cell injections in both knees. He believes that without treating the lymphedema, the knee injections would not be successful.

    I would like to know if you have come across similar cases as mine; lymphedema and bad joints. I’m a bit skeptical of the lymphedema treatment, mostly due to lack of proven clinical trials (specifically Umbilical Cord stem cell) and having been told that lymphedema in merely manageable. Any information you can provide or research you can point me towards would be very helpful.

    Thank you.

  14. Hi Josh,

    I’m sorry to hear about your combination of knee trouble and lymphedema. Having this combination in both legs must be quite limiting for you. As you might expect, I’m rather skeptical about the advice that you received. I LOVE the potential of stem cell therapies, but the field is still massively dominated by hype rather than substance. There are countless well-meaning physicians, surgeons and scientists touting the benefits of these cells, but the majority of these people appear to be more focused on publishing papers (the currency of scientific fame) rather than doing evidence-based clinical research that might actually have a chance of helping people in the real world. This is a harsh assessment, but I stand by it.

    If someone suggests that you should consider intravenous injections of stem cells to treat your lymphedema before receiving knee injections of stem cells to fix your knee cartilage, be VERY skeptical of all advice that you receive from them. Treating stems cells as magical potions that miraculously cure whatever ails you is incredibly naive. It’s akin to going to a cutting-edge research hospital and receiving a consultation by a witch doctor. What source of stem cells? How should they be treated in vitro before transplantation? How should they be delivered, and with what other proteins and co-factors? What is the predicted mechanism of action and outcome and how will this be measured? What human clinical research supports this combination of variables? Has this treatment be attempted at this center, and what was the outcome?

    I would feel great about a physician who instead responded to your inquiry with something like: “You should consider seeing a therapist trained in Combined (or ‘Complex’) Decongestive Therapy to get your primary lymphedema under maximal control before considering our experimental stem cell trial for knee cartilage regeneration. This may best increase your chances of having a positive outcome. Have you also tried non-invasive approaches to help control your knee symptoms, such as physical therapy? Strengthening the muscles around your knee joints can help reduce symptoms, but cannot help you regrow your cartilage. Strengthening through physical therapy BEFORE and AFTER surgical interventions has also been shown to improve outcomes, so regardless of how you decide to proceed, you should consider adding this approach to your treatment path. No, I am not aware of any promising clinical trials for treating primary lymphedema with stem cell therapy, but this is an interesting field that I would like to learn more about. We would love to include you in our experimental trial if you meet the inclusion criteria and you have discussed all of your options with your family physician first. Depending on what you family physician says, you may also want a consult with an orthopedic surgeon to more clearly understand your surgical options.”

    I want to tell you that your leg issues are going to be solved by injections of stem cells, but this field is still in an experimental stage. You might see permanent relief from this approach, or you might see temporary relief, or you might see no relief at all. I obviously don’t know what exactly this group intends to do, nor what clinical research supports their specific approach. However, if you take the bulk of existing stem cell clinical trials as a guide, it’s more likely that you will see no net benefit. This will eventually change as the science develops, and hopefully this will come sooner than later!

    Feel free to explore these experimental approaches (participating also helps push the science forward!), but play a conservative game as well: learn the proven ways to get your lymphedema and knee pain under maximal control. This will improve your quality of life and give you the best chance of getting the most benefit out of any experimental or surgical approach as well.

    Best of luck!

  15. Josh M Josh M says:

    Dr. Davey,

    Thank you so very much for your reply. It is definitely informing and will take it all into consideration.

    I did have some things I wanted to clarify. The consultation was with Dr. Vernon Williams, and it was not for a clinical trial, but an injection of Umbilical Cord Stem Cells in the knees. He did provide testimonials of his patients that had success with that type of treatment. I am skeptical of the treatment for the knees, and very skeptical of the intravenous treatment. I have been going to physical therapy and noticed an improvement in my strength and mobility. And also continue aquatic therapy as well.

    I would be interested in a clinical trial, what type of stem cell would be used. I’ll continue to research the treatment styles as well.
    Regards

    Josh M.

  16. I had assumed he was doing a clinical trial because this type of treatment is not yet proven to be clinically effective – it doesn’t mean that he isn’t allowed to use it (as long as it is safe), but it’s putting the cart before the horse. Good for you being skeptical, and also for taking conservative therapy approaches in concert. Best of luck.

  17. Chaney Ferguson Chaney Ferguson says:

    Hi Dr. Davey! I am so happy I found this article, because I’m hoping to get my own story out to give hope to others. I was diagnosed with secondary Lymphedema in both legs at the age of 24 in 2004. I worked very hard to take are of myself with the few tools I was given: compression stockings, I purchased a lymph drainage pump to have at home and frequented a massage therapist. In 2016 I had been suffering with an unrelated hip injury, and after 2 surgeries, I was desperate enough to undergo adipose stem cell therapy as a last ditch effort fit my hip pain. Not only did my hip get better (tendonosis) but gradually I noticed my lymphedema symptoms were getting better. I had had a baby before the stem cell therapy, and had massive swelling the whole second half of my pregnancy. Then I had a second baby after the stem cells, and only had to wear my compression stockings a few times toward the very end of the pregnancy. I am now 8 months post-partum and never wear stockings during the day, and very rarely at night. If I ever need them it’s because I’ve been drinking alcohol and sitting for extended amount of time. I am up on my feet all day taking care of a toddler and a newborn and at the end of the day I have no pain and can actually still see me ankle bones and tendons in my feet. My feet are actually the skinniest part of my body, which is something I knew I would never get to say when I was diagnosed at 24. I hope my story can help someone out there and give them hope.

  18. Thanks for sharing your story Chaney!

  19. Bethany Bethany says:

    Chaney Ferguson, I just read your story and am super excited to learn more! I’ve had primary lymphedema since I was 11 and I’m now 28. Would you be open to emailing me so I could ask more questions about your procedure?? If so let me know and I’ll post my email address here.

    Thank you!

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