Autologous Stem Cells Transplantation for No-Option Angiitis-Induced Critical Limb Ischemia: Recurrence and New Lesion.
Autologous Stem Cells Transplantation for No-Option Angiitis-Induced Critical Limb Ischemia: Recurrence and New Lesion.
复制标题
自体干细胞移植无侵蚀血管炎诱导的临界肢体缺血：复发和新病变。
DOI：
10.1093/stcltm/szac017
复制
发表时间：
2022-05-27
影响因子：
6
通讯作者：
Dong, Zhihui
中科院分区：
文献类型：
--
作者：
Liu, Hao;Fang, Yuan;Pan, Tianyue;Fang, Gang;Liu, Yifan;Jiang, Xiaolang;Chen, Bin;Gu, Shiyang;Wei, Zheng;Liu, Peng;Fu, Weiguo;Yang, Jue;Dong, Zhihui
虽然自体干细胞移植治疗血管炎引起的严重肢体缺血（AICLI）已取得令人满意的结果，但很少有研究系统地报道复发情况。在本研究中，我们的目的是在长期随访期间调查我们中心一个相对较大的AICLI队列的复发情况。2009年5月至2020年8月，181例AICLI患者接受了外周血单个核细胞（PBMNCs）或纯化CD 34+细胞（PCCs）移植。主要结局包括复发和新病灶。患者人口统计学数据、缺血肢体特征、介入特征等，进行了鉴定和分析。Logistic多变量回归通过逐步选择变量来确定复发的独立危险因素。本研究入组了148例患者。平均随访时间为62.3 ± 37.4个月（范围12-144个月）。5年和10年无复发率分别为88.5%（95%置信区间[CI] 3.1%-82.6%）和71.7%（95% CI 7.6%-58.2%）。5年和10年新发无病变率分别为93.2%（95% CI 2.2%-89.0%）和91.7%（95% CI 2.7%-86.6%）。多肢受累（OR 1.322 95% CI 1.123-12.549，P = .036）和缺血缓解期≥5个月（OR 3.367 95% CI 1.112-10.192，P = .032）是行细胞移植的AICLI患者复发的独立危险因素。对于对细胞移植有反应的AICLI患者来说，这种疗法的持久性令人满意，5年和10年无复发率分别为88.5%和71.7%。入院时多肢受累和缺血缓解期≥5个月是移植术后复发的独立危险因素。多肢缺血的AICLI患者似乎更容易在细胞移植后复发。AICLI，血管炎引起的严重肢体缺血。
Although satisfying outcomes have been demonstrated in terms of autologous stem cell transplantation in the treatment of angiitis-induced critical limb ischemia (AICLI), few studies have systematically reported the recurrence conditions. In the current study, we aimed to investigate recurrence conditions of a relatively large AICLI cohort in our center during a long-term follow-up period. From May 2009 to August 2020, 181 patients with AICLI received peripheral blood mononuclear cells (PBMNCs) or purified CD34+ cells (PCCs) transplantation. The main outcomes included recurrence and new lesions. Patient demographic data, ischemic limb characteristics, interventional characteristics, etc., were identified and analyzed. A logistic multivariable regression was performed to identify the independent risk factors for recurrence by a stepwise selection of variables. One hundred forty-eight patients were enrolled in this study. The mean follow-up period was 62.3 ± 37.4 months (range 12-144 months). The 5- and 10-year recurrence-free rates were 88.5% (95% confidence interval [CI] 3.1%-82.6%) and 71.7% (95% CI 7.6%-58.2%), respectively. The 5- and 10-year new lesion-free rates were 93.2% (95% CI 2.2%-89.0%) and 91.7% (95% CI 2.7%-86.6%), respectively. The finding of multiple limbs involved (OR 1.322 95% CI 1.123-12.549, P = .036) and ischemia relief period ≥5 months (OR 3.367 95% CI 1.112-10.192, P = .032) were demonstrated to be independent risk factors for recurrence in patients with AICLI who underwent cell transplantation. For patients with AICLI who responded to cell transplantation, the durability of this therapy was satisfactory, with 5- and 10-year recurrence-free rates of 88.5% and 71.7%, respectively. Multiple limbs involved at admission and ischemia relief period ≥5 months were demonstrated to be independent risk factors for recurrence after transplantation. AICLI patients with multiple ischemic limbs seem to be more likely to develop recurrence after cell transplantation. AICLI, angiitis-induced critical limb ischemia.
登录
查看更多内容
影响因子：
1.3
作者：
Baran, Cagdas;Durdu, Serkan;Akar, Ruchan
通讯作者：
Akar, Ruchan
影响因子：
3.3
作者：
Yusoff, Farina Mohamad;Kajikawa, Masato;Higashi, Yukihito
通讯作者：
Higashi, Yukihito
DOI：
10.1161/atvbaha.109.198895
发表时间：
2010-06-01
影响因子：
8.7
作者：
Kumar, Arun H. S.;Caplice, Noel M.
通讯作者：
Caplice, Noel M.
影响因子：
2.6
作者：
Kum, Steven;Tan, Yih Kai;Mutirangura, Pramook
通讯作者：
Mutirangura, Pramook
影响因子：
20.1
作者：
Friedrich, EB;Walenta, K;Werner, N
通讯作者：
Werner, N