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ȣ - 480393 94 |
| Clinical Safety and Feasibility of G-CSF mobilized Peripheral Blood Stem Cell Therapy in Myocardial Infarction patients: MAGIC Cell investigator[Myocardial Regeneration and Angiogenesis in MI with G-CSF Mobilization and Intra-Coronary Cell Infusion] |
| 서울대학교의과대학 내과학교실¹ ;서울대학교병원 임상의학연구소 심혈관연구실² ;서울대학교병원 진단검사의학교실³ |
| 나상훈¹, 강현재¹ ,조현재¹ ,장서영² ,정진욱¹ ,조영석¹ ,연태진¹ ,구본권¹ ,김용진¹ ,채인호¹ ,최동주¹ ,김효수¹ ,손대원¹ ,한규섭³ ,오병희¹ ,이명묵¹ ,박영배¹ ,최윤식¹ |
BACKGROUND: Intracoronary infusion of peripheral blood stem cells(PBSC) mobilized with G-CSF stimulation has been shown to improve cardiac function in myocardial infarction(MI)patients[MAGIC-I trial].Aging and other risk factors have been reported modifying factors for efficacy of G-CSF induced PBSC mobilization in healthy bone marrow donor.We examined the safty and feasibility of G-CSF stimulated peripheral blood apheresis for stem cell source in MI patients. METHODS AND RESULTS: From Feb 2003 to Aug 2004, 51 MI patients were included in this study.PBSC apheresis product collections after G-CSF stimulation were performed with a COBE cell separator.FACS analysis was done with apheresis products.The study group was composed of 20 AMI(≤14 days) and 31 OMI patients,with a mean[SD] age of 58.7[10.3].During G-CSF injection and peri-apheresis period,we did not observe aggravation of angina,any ECG changes suggesting ischemia or substantial arrhythmia,or thrombotic complication.We collected 7.6[2.7]x109leucocytes(mononuclear cells:86.5%[12.0],CD34+ cells:9.7%[9.4]) during apheresis,and infused 1.43[0.4]x109collected leucocytes(volume: 9.3 mL [3.7]),1.32[1.34]x108CD34+cells,7.08[9.24]x107KDR+/CD34+cells,4.37[6.5]x106SH2+/SH3+cells by over-the-wire balloon angioplasty catheter after PCI to patients.In FACS analysis,apheresis cell products were composed of subpopulation of cells:KDR+(10.3%[10.9]),CD31+(50.5%[13.2]),vWF+(2.4%[4.9]),VE-cadherin+(1.8%[3.6])[endothelial marker];AC133+(1.1%[2.7]),CD34+(9.7%[9.4])[stem cell];CD14+(38.8%[19.3])[monocyte];CD45+(94.1%[3.3])[common leukocytes];SH2+/SH3+(0.34%[0.52])[mesenchymal stem cells];and KDR+/CD34+(3.4%[5.3])[endothelial progenitor cells].Age,diabetes,hypertension,presence of acute ischemia,and LV dysfunction did not show any difference with collected stem cell population numbers in subgroup analysis. CONCLUSIONS: G-CSF injection and G-CSF stimulated apheresis show no adverse effect in MI patients. There is no significant difference in mobilized stem cell population regardless of age, diabetes, presence of acute ischemia and LV dysfunction. This study suggests that G-CSF based PBSC therapy in MI is safe and feasible.
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