Long-Term Clinical Outcomes of Autologous Bone Marrow Mononuclear Cell Implantation in Patients With Severe Thromboangiitis Obliterans
Long-Term Clinical Outcomes of Autologous Bone Marrow Mononuclear Cell Implantation in Patients With Severe Thromboangiitis Obliterans
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DOI：
10.1253/circj.cj-19-1041
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发表时间：
2020-04-01
影响因子：
3.3
通讯作者：
Higashi, Yukihito
中科院分区：
文献类型：
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作者：
Yusoff, Farina Mohamad;Kajikawa, Masato;Higashi, Yukihito
背景：患有严重的Buerger病（也称为血栓闭塞性脉管炎（TAO））的患者有截肢的风险。研究表明，自体骨髓单个核细胞（BM-MNC）移植可改善TAO患者严重肢体缺血的状况。本研究的目的是进一步阐明TAO患者自体BM-MNC植入的长期（>10年）结果。方法和结果：对27例TAO患者47条下肢BM-MNC植入的长期结果进行了观察性研究。平均（+/- SD）随访期为12.0 +/- 8.6年。接受BM-MNC植入治疗的患者在长达10年的随访中未发生重大截肢事件。接受BM-MNC植入的患者的总体无截肢生存率显著高于内部对照和历史对照。历史对照组和内部对照组的无截肢存活率无显著差异。接受BM-MNC移植的患者和历史对照组的总生存率也没有显著差异。结论：BM-MNC移植成功地防止了没有其他治疗选择的严重TAO患者在>10年的时间内进行主要肢体截肢。
Background: Patients with severe Buerger disease, also known as thromboangiitis obliterans (TAO), are at risk of major limb amputation. It has been shown that autologous bone marrow mononuclear cell (BM-MNC) implantation improves the condition of critical limb ischemia in TAO patients. This study was conducted to further clarify the long-term (>10 years) results of autologous BM-MNC implantation in patients with TAO.Methods and Results: An observational study was conducted of the long-term results of BM-MNC implantation in 47 lower limbs of 27 patients with TAO. The mean (+/- SD) follow-up period was 12.0 +/- 8.6 years. There was no major amputation event up to 10 years of follow-up in patients treated with BM-MNC implantation. The overall amputation-free survival rates were significantly higher in patients who underwent BM-MNC implantation than in internal controls and historical controls. There was no significant difference in amputation-free survival rates between the historical and internal controls. There was also no significant difference in overall survival between patients who underwent BM-MNC implantation and the historical controls.Conclusions: BM-MNC transplantation successfully prevented major limb amputation over a period of >10 years in patients with severe TAO who had no other therapeutic options.