Stem cell therapy: a promising and prospective approach in the treatment of patients with severe Buerger's disease.

Abstract

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.

• Authors: Zoltan Boda, Miklos Udvardy, Katalin Rázsó, Katalin Farkas, Judit Tóth, Laszlo Jámbor, Zsolt Oláh, Peter Ilonczai, Mariann Szarvas, Janos Kappelmayer, Zoltan Veréb, Eva Rajnavölgyi
• Journal: Clinical and applied thrombosis/hemostasis : official journal of the International Academy of Clinical and Applied Thrombosis/Hemostasis (Clin Appl Thromb Hemost) Vol. 15 Issue 5 Pg. 552-60 (Oct 2009) ISSN: 1938-2723 [Electronic] United States
• PMID: 18818231 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Adult
• Amputation, Surgical (methods)
• Angiography (methods)
• Bone Marrow Transplantation (methods)
• Female
• Humans
• Male
• Middle Aged
• Prospective Studies
• Stem Cell Transplantation (methods)
• Thromboangiitis Obliterans (surgery)