Department of Cardiovascular Regeneration and Medicine, Research Institute for Radiation Biology and Medicine, Hiroshima University.
Division of Regeneration and Medicine, Medical Center for Translational and Clinical Research, Hiroshima University Hospital.
Circ J. 2020 Mar 25;84(4):650-655. doi: 10.1253/circj.CJ-19-1041. Epub 2020 Mar 3.
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.
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.
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.
患有严重伯格氏病（也称为血栓闭塞性脉管炎）的患者有发生主要肢体截肢的风险。已经证实，自体骨髓单个核细胞（BM-MNC）移植可改善血栓闭塞性脉管炎患者的严重肢体缺血状况。本研究旨在进一步阐明自体 BM-MNC 移植在血栓闭塞性脉管炎患者中的长期（>10 年）疗效。
对 27 例血栓闭塞性脉管炎患者的 47 条下肢进行了 BM-MNC 移植的长期疗效观察研究。平均（±SD）随访时间为 12.0±8.6 年。在接受 BM-MNC 移植治疗的患者中，随访 10 年以上无重大截肢事件。与内部对照组和历史对照组相比，接受 BM-MNC 移植的患者的无截肢生存率显著更高。历史对照组和内部对照组之间的无截肢生存率无显著差异。BM-MNC 移植组与历史对照组之间的总生存率也无显著差异。
对于没有其他治疗选择的严重血栓闭塞性脉管炎患者，BM-MNC 移植成功地预防了>10 年的主要肢体截肢。
