Clinical application of bone marrow implantation in patients with arteriosclerosis obliterans, and the association between efficacy and the number of implanted bone marrow cells.
BACKGROUND
There have been a number of recent reports on the use of autologous bone marrow implantation (BMI) in the treatment of peripheral arterial disease, with a clinical response rate of approximately 70%. However, the factors that influence efficacy have not yet been clarified. We have analyzed the relationship between the number of implanted bone marrow cells and the clinical efficacy of BMI.


RESULTS
Eight patients with arteriosclerosis obliterans were treated with BMI. Bone marrow was aspirated from the ilium (500-1,000 ml), the mononuclear cells were separated and then were implanted. The clinical effectiveness of BMI was evaluated by assessing changes in the ankle-brachial pressure index (ABI) and the transcutaneous oxygen pressure (TcO2) between the pre-treatment baseline, with follow-up testing at 4 weeks. These changes were defined as DeltaABI and DeltaTcO2. The mean number of CD34-positive cells was 1.04+/-0.60 x10(6) /kg body weight. There was a strong correlation between the number of CD34-positive cells and DeltaABI (r=0.754, p=0.028).


CONCLUSIONS
It is likely that the number of implanted CD34-positive cells is one of the primary factors that influence the clinical efficacy of BMI.
Saigawa
Takashi
T
Division of Cardiology, Niigata University Graduate School of Medical and Dental Sciences, Asahimachi, Niigata-City, Niigata, Japan.
Kato
Kiminori
K
Ozawa
Takuya
T
Toba
Ken
K
Makiyama
Yashiro
Y
Minagawa
Shiro
S
Hashimoto
Shigeo
S
Furukawa
Tatsuo
T
Nakamura
Yuichi
Y
Hanawa
Haruo
H
Kodama
Makoto
M
Yoshimura
Nobuhiko
N
Fujiwara
Hiroshi
H
Namura
Osamu
O
Sogawa
Masakazu
M
Hayashi
Jun-ichi
J
Aizawa
Yoshifusa
Y
D000368:Aged; D015901:Angiography, Digital Subtraction; D000842:Ankle / Q000098:blood supply; D018952:Antigens, CD34 / Q000032:analysis; D001162:Arteriosclerosis Obliterans / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000601:surgery*; D001785:Blood Gas Monitoring, Transcutaneous; D001794:Blood Pressure; D001854:Bone Marrow Cells / Q000276:immunology; D016026:Bone Marrow Transplantation; D001916:Brachial Artery / Q000503:physiopathology; D002452:Cell Count; D003097:Collateral Circulation; D005260:Female; D006801:Humans; D007866:Leg / Q000098:blood supply; D008297:Male; D008875:Middle Aged; D018919:Neovascularization, Physiologic; D016896:Treatment Outcome; D014463:Ultrasonography
D018952:Antigens, CD34