Purpose: 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.
Methods: 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.
Results: 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 ×
109 and 16.5 × 109, and that of CD34+ cells, between 0.1 ×
106 and 12.7 × 106, 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.
Conclusions: Erythropoietin-induced autologous peripheral
blood-MNC transplantation is a useful and safe alternative for ischemic limbs.