Autologous Stem Cells Transplantation for No-Option Angiitis-Induced Critical Limb Ischemia: Recurrence and New Lesion

Author:

Liu Hao12,Fang Yuan12,Pan Tianyue12,Fang Gang12,Liu Yifan12,Jiang Xiaolang12,Chen Bin12,Gu Shiyang3,Wei Zheng3,Liu Peng3,Fu Weiguo12,Yang Jue12,Dong Zhihui12ORCID

Affiliation:

1. Department of Vascular Surgery of Zhongshan Hospital, Fudan University , Shanghai , People’s Republic of China

2. National Clinical Research Center for Interventional Medicine , Shanghai , People’s Republic of China

3. Department of Hematology of Zhongshan Hospital, Fudan University , Shanghai , People’s Republic of China

Abstract

Abstract 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.

Funder

China National Natural Science Funds

Shanghai Excellent Academic Leader

Fudan University “Star of Tomorrow” Famous Doctor Training Project

Shanghai Sailing Program

Shanghai Interventional Therapy Engineering Technology Research Center

Clinical Excellent Doctor Training Project

Publisher

Oxford University Press (OUP)

Subject

Cell Biology,Developmental Biology,General Medicine

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