Analysis of possible factors relating to prognosis in autologous peripheral blood mononuclear cell transplantation for critical limb ischemia |
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| Affiliation: | 1. General Medical Center of the Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China;2. Department of Hematopoietic Stem Cell Transplantation, Hospital Affiliated with the Academy of Military Medical Sciences, Beijing, China;1. Humanitas Clinical and Research Center, Rozzano, Milan 20089, Italy;2. Centro Ricerca Tettamanti, Department of Pediatrics, University of Milano-Bicocca, Fondazione MBBM/San Gerardo Hospital, Monza 20900, Italy;3. Humanitas University, Rozzano, Milan 20089, Italy;1. Centre de Recherche du CHU Ste-Justine, Université de Montréal, Montréal, Québec, Canada;2. Département de Pharmacologie, Université de Montréal, Montréal, Québec, Canada;3. Département de Somatologie, Université de Montréal, Montréal, Québec, Canada;1. Department of Vascular Surgery, Zhongnan Hospital of Wuhan University, Zhongnan Hospital, Wuhan city, Hubei province, China;2. Department of Vascular Surgery, Affiliated Xiangyang Central Hospital of Hubei University of Arts and Science, Xiangyang Center Hospital, Xiangyang city, Hubei province, China;3. Department of Pharmacy, Affiliated Xiangyang Central Hospital of Hubei University of Arts and Science, Xiangyang Center Hospital, Xiangyang city, Hubei province, China;1. Division of Cardiovascular Medicine, Toho University Ohashi Medical Center, Tokyo, Japan;2. Division of Nephrology, Toho University Ohashi Medical Center, Tokyo, Japan;1. Department of Orthopedics, Shanghai Jiao Tong University Affiliated Sixth People''s Hospital, Shanghai, China;2. Shanghai Key Laboratory of Orthopedic Implants, Department of Orthopedics, Ninth People''s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China;1. Center for Cell and Gene Therapy, Baylor College of Medicine, The Methodist Hospital, and Texas Children''s Hospital, Houston, Texas, USA;2. Dan L. Duncan Cancer Center, Baylor College of Medicine, The Methodist Hospital, and Texas Children''s Hospital, Houston, Texas, USA;3. Program for Cell Enhancement and Technologies for Immunotherapy, Center for Cancer and Immunology Research, and Sheikh Zayed Institute for Pediatric Surgical Innovation, Children''s National Health System, Washington, DC, 20010;4. Department of Stem Cell Transplantation and Cellular Therapy, MD Anderson Cancer Center, Houston, Texas, USA |
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| Abstract: | Background aimsAutologous transplantation of granulocyte colony-stimulating factor–mobilized peripheral blood mononuclear cells (M-PBMNCs) has been shown to be effective in treating critical limb ischemia (CLI); however, the studies of the possible prognosis predictors after autologous M-PBMNC transplantation are inadequate. The objective of the study was to assess the possible factors affecting the results of M-PBMNC transplantation for CLI.MethodsWe reviewed the clinical profiles of 87 patients with CLI who were treated with M-PBMNC implantation in the Blood Diseases Hospital, Chinese Academy of Medical Sciences, between December 2002 and December 2011, and we followed these patients. The patients were divided into a good prognosis group and a poor prognosis group on the basis of whether amputation was performed. The significant differences of clinical variables between two groups were analyzed by means of the Mann-Whitney test and χ2 test, and logistic regression analysis was used to study the variables representing the possible prognostic factors for amputation.ResultsOf the 87 patients, three patients died and one patient was lost during the follow-up period. We analyzed 83 patients. The diseases included CLI complicated by diabetes mellitus gangrene (35 cases, 42.2%), arteriosclerosis obliterans (31 cases, 37.3%) and thromboangiitis (17 cases, 20.5%). The mean age was 62 years (range, 30–87). The median follow-up time for the surviving patients was 5 years. The 5-year amputation-free rate was 72.2%, and no adverse effects related to M-PBMNC transplantation were observed.ConclusionsThe significant prognostic factors associated with poor angiogenesis were fibrinogen >4 g/L and fasting blood glucose >6 mmol/L. |
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| Keywords: | critical limb ischemia peripheral arterial disease peripheral blood mononuclear cell transplantation prognostic factor |
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