Background : Recent clinical trials implicate cell therapy with peripheral blood stem cells (PBSC) as a promising treatment for saving ischemic myocardium. Here, we report our experience of mobilization of PBSC in patients with myocardial infarction and result of comparison of mobilization capacity between acute and old myocardial infarction (AMI and OMI).
Methods : Patients with AMI (n=46) and OMI (n=28) were enrolled. Patients who have significant coronary lesion underwent stent implantation before G-CSF treatment. All the patients were given 10關g/Kg/day of G-CSF for 3 days for peripheral stem cell mobilization. After 3 days of G-CSF treatment, peripheral mononuclear cells were collected by apheresis. Characteristics of collected cells were evaluated with flow cytometry analysis.
Results : There is no serious adverse events related to G-CSF injection and apheresis. Number of peripheral blood leukocytes after completion of G-CSF injection did not differ between groups. However, OMI group required longer apheresis processing time (81.0짹22.2ml vs 92.1짹27.7ml, p=0.08) and larger blood volume to collect target cell number (5,515짹958 ml vs. 6043짹1078ml, p=0.048). Yield of CD34 positive cells was similar in both AMI and OMI groups (15.1짹14.6% vs. 12.15짹10.2%, p=0.36), however kinase insert domain receptor (KDR)/CD34 double positive cells significantly increased in AMI group (10.1짹15.4% vs. 1.84짹2.31%, p=0.001) which suggests increased number of endothelial progenitor cells(EPC) in apheresis product.
Conclusion : G-CSF based stem cell mobilization and collection is safe and feasible for stem cell therapy. Mobilization and collection of PBSC is more efficient in AMI than OMI.