The effects and safety of autologous peripheral blood stem cell mobilization by-CSF in patients with acute myocardial infarction / 介入放射学杂志

ABSTRACT

Objective Observed the mobilization effects、 the safety and feasibility of autologous circulating blood stem cell by G-CSF in acute myocardial infarction (AMI). Methods 45 patients with AMI were randomly allocated to receive either inclusive type Granulocyte Colony-Stimulating Factor (G-CSF), to mobilize the stem cell. The patients received the dose of G-CSF 300?g-600?g/day, by hypodermic injection, and the duration of applying G-CSF was 5 days. In the process of the mobilization of the circulating blood stem cell, prior to applying G-CSF and on the 3rd、4th、5th、6th、7th after applying G-CSF, the white blood cell (WBC) and CD34+ cell count in the circulating blood should be observed; and the following side effects also should be paid attention to, such as bone pain, tetter, fever, gastrointestinal effects( nausea 、vomit、 coprostatis ),deteriorated of angina or heart failure and some rare effects(spontaneous spleen rupture, severe purulent infection, hypercoagulable state, autologous immune diseases). Results Prior to applying G-CSF and the 3rd、4th、5th、6th、7th after applying G-CSF, the counts of WBC were (8.42?2.59)?10 9/L、(31.28?8.34)?10 9/L、(35.24?9.38)?10 9/L、(37.03?13.07)?10 9/L、(35.34?14.68)?10 9/L、(20.35?9.22)?10 9/L;the counts of CD34+ cell were (14.89?11.46)?10 6、(67.78?50.88)?10 6、(124.79?136.13)?10 6、(208.92?206.97)?10 6、(206.10?184.57)?10 6、(66.63?56.56)?10 6;The peak of curve that WBC and CD34 + cell count changed with applying days was on the 5th .The count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood(r=0.835);was not reference with age、 sex、body weight、and the onset time of AMI. There were total 17 complications during the mobilization of circulating blood stem cell. The incidence of complications during mobilization is 37.8%(17/45), including bong pain being 15.6%(7/45)、fever being 6.7 %(3/45)、pale being 4.4 %(2/45)、tetter being 4.4 %(2/45)、deterioration of heart failure being 4.4 %(2/45),spleen thrombosis being 2.2 %(1/45).No death happened. Conclusion: In patients with AMI, the mobilized peak of WBC and CD34 + cell counts changed with applying days was at the 5th, and the count of CD34 + cell in the circulating blood was positive referent with the count of WBC in the circulating blood(r=0.940),was negative referent with body weight of patients(r=-0.398). And mobilization of autologous circulating blood stem cell was feasible and safe.