Abstract:

BACKGROUND: Autologous stem cell transplantation in the treatment of lower limb ischemia has been developed extensively in domestic and overseas and achieved better clinical curative effect. 5-10 μg/(kg • d) of granulocyte colony-stimulating factor (G-CSF) mobilization is often used, and stem cells are harvested after 5 days for transplantation. Whether the above-mentioned is the optimal mobilization scheme and harvesting opportunity is not reported.
OBJECTIVE: To explore the best mobilizing scheme and harvesting opportunity and to increase the security of the treatment.
METHODS: Eighteen diabetes foot patients preparing for stem cell transplantation were enrolled. G-CSF of 5-10 μg/(kg • d) was used for mobilizing hematopoietic stem cells. The relations between mobilization dose and days of G-CSF and the numbers of WBC, peripheral single nuclear cells and CD34⁺ were analyzed. Coagulation indexes and platelet count were detected before and after mobilization and collecting. Patients’ adverse effects were observed during process of acquisition and mobilization.
RESULTS AND CONCLUSION: The acquisition efficiency of stem cells was closely related to mobilization dose and days of G-CSF. There were no significant changes in coagulation indexes before and after mobilization and collecting. Platelet count had no change before and after mobilization, but dropped dramaticlly after collecting .There was only one patient with mild bone ache and one patient who had a fever during the mobilization. Other patients all had no obvious adverse effects. The optimal time of stem cell collecting for patient with diabetic foot is decided by the number of peripheral blood mononuclear cells and CD34⁺ cells, not only by mobilization days and white blood cells counts. Mobilization and collecting of stem cells has a smaller effect on patients and a higher security.