Abstract
In this study, we report the comparative result of long-term clinical prognoses for patients with no-option critical limb ischemia (CLI) caused by arteriosclerosis obliterans, who are implanted with autologous bone marrow mononuclear cells (BMMNC; n=74) or G-CSF-mobilized (M)-PBMNC (n=111), as no information is available on how the two treatments compare in terms of long-term prognosis, such as survival or amputation. We performed pooled analysis using data from two previous cohort studies. All patients had disease of Fontaine classification III or IV. The endpoints were OS and amputation-free survival (AFS). After adjustment for history of dialysis and Fontaine classification, there was no significant difference between the two treatments with respect to OS (hazard ratio (HR)=1.49; 95% confidence interval (CI)=0.74–3.03, P=0.26) or AFS (HR=0.96; 95% CI=0.61–1.51, P=0.87). The negative prognostic factors affecting OS or AFS were the small number of CD34-positive cells collected, history of dialysis, Fontaine classification, male sex and older age. These results suggest that there was no significant difference in long-term prognosis between patients treated with BMMNC and those treated with M-PBMNC. The number of CD34-positive cells collected was an important prognostic factor for amputation and death.
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Appendix
Appendix
BMMNC follow-up study investigators
Kyoto Prefectural University of Medicine: Satoaki Matoba, Tetsuya Tatsumi, Hiroaki Matsubara. Nagoya University Graduate School of Medicine: Toyoaki Murohara, Takahisa Kondo. Kurume University School of Medicine: Tsutomu Imaizumi, Yousuke Katsuda, Yasuyuki Toyama. Gunma University School of Medicine: Shigeru Saito, Saiseikai Wakayama Hospital: Hiroyoshi Komai. Mie University Graduate School of Medicine: Masaaki Ito, Hitoshi Iwasaki. Nara Medical University: Yoshihiko Saito, Satoshi Okayama. Showa University School of Medicine: Hiroshi Suzuki, Teruko Hayada. Osaka City University Graduate School of Medicine: Shinya Fukumoto. Kochi University School of Medicine: Hironori Maeda. Tottori University Graduate School of Medical Science: Yasutaka Yamamoto.
M-PBMNC follow-up study investigators
Department of Surgery, Sapporo Hokuyu Hospital: Takashi Horie, Akio Kawamura. Department of Hemodialysis and Aphaeresis, Itabashi Chuo Hospital: Makoto Akamastu. Kanagawa Cardiovascular and Respiratory Center: Yukio Ichikawa. Kidney Center, Toranomon, Hospital: Junichi Hoshino. Department of Geriatrics and Vascular medicine, Tokyo Medical and Dental University: Eiji Kaneko. Department of Surgery, National Hospital Organization Chiba-East Hospital: Chikara Iwashita. Department of Transfusion Medicine and Cell Therapy, Faculty of Medicine, Keio University: Akaru Ishida. Hemodialysis and Aphaeresis Center, Kitano Hospital, The Tazuke Kofukai Medical Research Institute: Tatsuo Tsukamoto.
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Onodera, R., Teramukai, S., Tanaka, S. et al. Bone marrow mononuclear cells versus G-CSF-mobilized peripheral blood mononuclear cells for treatment of lower limb ASO: pooled analysis for long-term prognosis. Bone Marrow Transplant 46, 278–284 (2011). https://doi.org/10.1038/bmt.2010.110
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DOI: https://doi.org/10.1038/bmt.2010.110
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