Autologous Peripheral Blood-Derived Mononuclear Cells Induced by Erythropoietin Improve Critical Ischemic Limbs

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Author(s)

    • Kanbara Tamotsu
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Sata Masataka
    • Department of Cardiovascular Medicine, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Matsumoto Toshio
    • Department of Medicine and Bioregulatory Sciences, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Kitagawa Tetsuya
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Kurobe Hirotsugu
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Kitaichi Takashi
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Sugano Mikio
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Nakayama Taisuke
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Kinoshita Hajime
    • Department of Cardiovascular Surgery, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Iwase Takashi
    • Department of Cardiovascular Medicine, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Akaike Masafumi
    • Department of Cardiovascular Medicine, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan
    • Abe Masahiro
    • Department of Medicine and Bioregulatory Sciences, Institute for Health Biosciences, The University of Tokushima Graduate School, Tokushima, Tokushima, Japan

Abstract

<b>Purpose:</b> Efficient and secure collection of CD34+ cells are crucial for the angiogenic therapies. We have developed autologous peripheral blood-mononuclear cell (MNC) transplantation induced by erythropoietin (rhEPO) for critical ischemic limbs.<br><b>Methods:</b> Seven patients, including five with arteriosclerosis obliterans, one with Buerger's disease and one with progressive systemic sclerosis, underwent ten cell therapies. The first administration of rhEPO was performed two weeks before apheresis, and the second administration and blood donation were performed one week before apheresis to activate bone marrow. MNCs including CD34+ cells, isolated from peripheral blood by apheresis, were immediately injected intramuscularly into ischemic limbs.<br><b>Results:</b> The number of peripheral blood-CD34 + cells had significantly increased from 1.32 ± 0.83/microL, before the rhEPO induction, to 1.86 ± 0.94/microL, before the apheresis. The number of transplanted MNCs ranged between 0.5 × 10<sup>9</sup> and 16.5 × 10<sup>9</sup>, and that of CD34+ cells, between 0.1 × 10<sup>6</sup> and 12.7 × 10<sup>6</sup>, accounting for 0.02%-0.1% of MNCs. There were no serious complications. Finger ulcers with Buerger's disease were significantly improved one month after the transplantations, but the same or other ulcer(s) appeared 2-6 months later. Three patients had an improvement in rest pain, and one patient extended maximum pain-free walking distance.<br><b>Conclusions:</b> Erythropoietin-induced autologous peripheral blood-MNC transplantation is a useful and safe alternative for ischemic limbs.

Journal

  • Annals of Vascular Diseases

    Annals of Vascular Diseases 5(1), 52-60, 2012

    The Editorial Committee of Annals of Vascular Diseases

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