Autológ csontveloi eredetu ossejtterápia eredmńye elorehaladott perifériás artériás érbetegségben

Translated title of the contribution: A pilot study with autologous bone marrow-derived stem cell therapy in patients with severe peripheral arterial disorder

Zoltán Boda, Miklós Udvardy, Katalin Farkas, Judit Tóth, László Jámbor, Pál Soltész, K. Katalin Rázsó, Zsolt Oláh, Péter Ilonczai, Mariann Szarvas, Krisztina Litauszky, János Hunyadi, Tamás Sipos, János Kappelmayer, Zoltán Veréb, Éva Rajnavölgyi

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Background and aims: Amputation is the only current option for relief of rest pain or gangrena in patients with severe peripheral arterial disease. Up to now, no effective blood-flow enhancement therapies are available. Autologous bone marrow-derived stem cell transplantation is an arising therapy modality with an option of building new blood vessels through endothelial stem and/or progenitor cells. Patients and methods: Five patients with severe peripheral arterial disorder were treated by autologous bone marrow-derived stem cell therapy. CD34+, CD133+ and CD45± cell number and ratio were determined. CD34+ cells were isolated by magnetic separation and collected into a 10 ml sample. The cell suspension was administered by local intramuscular injections (0.5-1.0 ml injections in the musculus gastrocnemius). The follow-up (before; 1, 3, 6, 9 and 12 months after the autologous bone marrow-derived stem cell therapy) based on clinical (rest pain, walking distance without pain, changes of non-healing ischaemic ulcers, ankle-brachial index) and laboratory (angiography, Color- and Laser-Doppler scan, measurement of transcutaneous oxygen tension and endothel function test) parameters was documented and analyzed. Results: Improvement of pain and walking distance was observed in all five cases. In three cases the non-healing ischaemic ulcers disappeared, in one other case they became smaller and thinner, and in one case no change was realized. The average of ankle-brachial index improved significantly (before: 0.41, twelve months after: 0.83). New collaterals were detected by angiography in three patients, but duplex ultrasonography detected improvement in one patient only. Before and 1, 6 and 12 months after stem cell therapy the transcutaneous oxygen tension changed on the foot from 18.80/16.78/23.83/37.50 mmHg, and on the calf from 36.66/31.25/45.00/37.30 mmHg. The macro- and microcirculation parameters did not show improvement after 1 month, however, after 3, 6, 9 and 12 months improved parameters were recorded. Severe adverse events were not observed. In one case elevated level of serum creatinin phosphokinase, and in another case a mild form of vasculitis were detected. Conclusion: Autologous bone marrow-derived stem cell therapy with isolated CD34+ cells is effective, safe and results in sustained clinical benefit for patients with severe peripheral arterial disease.

Original languageHungarian
Pages (from-to)531-540
Number of pages10
JournalOrvosi hetilap
Volume149
Issue number12
DOIs
Publication statusPublished - Mar 23 2008

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ASJC Scopus subject areas

  • Medicine(all)

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