Stem cell therapy: a promising and prospective approach in the treatment of patients with severe Buerger's disease.
No effective blood-flow enhancement therapies are available for patients with severe peripheral arterial disease (SPAD), thus amputation remains the only option for relief of rest pain or gangrene. Autologous bone marrow-derived stem cell therapy (ABMSCT) is an emerging modality to induce angiogenesis from endothelial progenitors. A total of 5 patients with SPAD were treated by ABMSCT using isolated CD34+ cells with characterized phenotype administered by intramuscular injections. The follow-up before and 1, 3, 6, 9, and 12 months after ABMSCT was based on clinical (rest pain, walking distance without pain, nonhealing ulcers, ankle-brachial index [ABI]) and laboratory (angiography, duplex and laser ultrasonography, TcPO(2)) parameters. Significant improvement of pain and walking distance was observed in all patients. Nonhealing ulcers disappeared in 3 patients and became smaller and thinner in 1 patient. The average of ABI improved significantly on the treated limb but did not change on the contralateral limb. New collaterals were detected by angiography in 3 patients, but duplex ultrasonography detected improvement in one patient only. Laser ultrasonography showed a mild significant change, TcPO(2) values improved mainly on the foot. Severe adverse events were not observed. We conclude that ABMSCT with isolated CD34+ cells is safe, effective, and results in sustained clinical benefit for patients with SPAD.
Boda
Zoltan
Z
2nd Department of Medicine, University of Debrecen, Debrecen, Hungary. zboda@dote.hu
Udvardy
Miklos
M
Rázsó
Katalin
K
Farkas
Katalin
K
Tóth
Judit
J
Jámbor
Laszlo
L
Oláh
Zsolt
Z
Ilonczai
Peter
P
Szarvas
Mariann
M
Kappelmayer
Janos
J
Veréb
Zoltan
Z
Rajnavölgyi
Eva
E
D000328:Adult; D000671:Amputation, Surgical / Q000379:methods; D000792:Angiography / Q000379:methods; D016026:Bone Marrow Transplantation / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D033581:Stem Cell Transplantation / Q000379:methods*; D013919:Thromboangiitis Obliterans / Q000601:surgery*