[Middle-term outcome of autologous bone marrow mononuclear cells transplantation for treatment of lower limb ischemia]

Abstract

Objective: To explore the middle-term outcome of autologous bone marrow mononuclear cells transplantation in the treatment of lower limb ischemia.

Methods: From March 2003 to June 2005, 65 patients with lower limb ischemia were treated by autologous bone marrow mononuclear cells transplantation. Of the patients, there were 50 males and 15 females, with a mean age of 66.5 years (range 36-89 years), including 4 cases of simple arteriosclerotic occlusion, 5 cases of thromboangiitis obliterans and 56 cases diabetic lower limb ischemia. A total of 400 mL bone-marrow blood were extracted from the posterior superior iliac crest. And then the mononuclear cells were isolated from the bone-marrow blood in the laboratory. The amount of transplantation bone marrow mononuclear cells was (0.60-1.80) x 10(9) (mean 1.05 x 10(9)). Twelve patients received cell transplantation from two to four times and the other patients one time. According to the improvement of clinical finding, the outcome was evaluated.

Results: All the patients were followed up for 8-56 months (mean 21.5 months). There were 8 deaths, and the mortality was 12.3%; 5 were due to myocardial infarction and heart failure and 3 were due to cerebral infarction. The general effective rate was 70.8% (46/65) and the recurrent rate was 10.7% (7/65). Of them, the response to treatment lasted over 12 months in 42 cases, accounting for 91.3% (42/46); over 24 months in 24 cases, accounting for 52.2% (24/46); and over 37 months in 12 cases, accounting for 26.1% (12/46). The effective rates were 100% in 12 patients who received 2-4 times transplantation and 64.2% in 53 patients who received 1 time transplantation, showing statistically significant difference between them (P < 0.001).

Conclusion: The middle-term outcome of autologous bone marrow mononuclear cells transplantation show that it is a feasible and simple method for treatment of lower limb ischemia.