Objective: To observe the clinical efficacy of autologous peripheral blood stem cells (PBSC) transplantation in 62 cases with ischemic lower extremity disorder.
Methods: Totally 62 patients with 34 cases of diabetic foot and 28 cases of various lower extremity ischemic disorders received recombinant human granulocyte-macrophage colony-stimulating factor (rhGM-CSF) 450 - 600 microg/d by hypodermic injection for 5 days to mobilize stem cells. On the sixth day, PBSC were collected by COBE 6.1 Spectra Version with an amount of 82 - 148 ml; the number of mononuclear cells (MNC) is (718.2 - 224.6) x 10(9)/L. CD34+ cells were tested. The PBSC were injected into the ischemic lower extremity and foot intramuscularly at 3 cm x 3 cm distance. The clinical and laboratory findings were monitored from first day to 24th week.
Results: In 62 patients with PBSC transplantation, free of severe pain was found in 54 cases (87.1%) from 7 to 30 days, improvement of foot cool feeling in 56 patients (90.3%) from 7 to 30 days, improvement of foot ulcer in 16 cases (40.0%) from 4 to 16 weeks. Ankle/brachial index (ABI) increased in 12 cases (34.3%), TcPO2 improved in 26 cases (42.3%). Digital subtraction angiographic scores were performed in 5 patients after 8 - 12 weeks, there was formation of new collateral vessels. No related complication or adverse effect was observed except in 2 patients with diabetic foot and cerebral infarction exacerbation of symptoms during the process of stem cells mobilization in all process.
Conclusion: Autologous PBSC transplantation might be a safe and effective method for lower extremity ischemic disorder. It could improve the quality of life of many patients as amputation of lower extremity or foot might be avoided.