Abstract 1181

Introduction:

Stem cells (SC) show a potential of cellular therapy in diffuse coronary disease with controverted results. We present here an analysis of a group of patients treated with TMLR plus ABMC. (Caiber Program Advanced Therapy Proyect FIS 2009).

Patients and methods:

19 patients with DCD were included. Age 66 (range: 52–78). ABMC were obtained by aspiration and processed using HARVEST-TM system -TALEX (Harvest Technologies Inc. GMBH, Munich) to obtain 20 ml. Surgery consisted of anterior thoracotomy incision at the fourth and fifth intercostal space. Between 15–30 transmyocardial channels were realized with TLMR PHOENIX-TM (Cardiogenesis, Irvine, CA, USA) and CrystalFlex 1 mm optical fibre. 0.5–2 cc of MO were administered in each channel. Total number CMN were determined by automatic cell counter and flow cytometry and were typified specific cell populations such as CD34+ and CD133+.

Results:

The duration of stem cell collection was less than 30 minutes. All the procedure was performed on surgery in 1 step. Any complications were observed with this technique. Correlation between the cellular count and demographic data was not observed. After a follow up of 22 months (5-36) only one patient has died (20m) of DCD. Initial clinical results are satisfactory with a significant reduction in the functional grade of angina.

Comments and conclusions:

Our data show that TMLR plus ABMC is a safe method with clinical efficacy in patients with DCD that are not candidate to other therapy options. The described method offers efficiency and simplicity to obtain cells. More cases and follow-up are required, as well as later functional evaluations.

TABLE 1
MEDIAN CMN (×106/ml)MEDIAN CD34+ (×106/ml)MEDIAN CD133+ (×106/ml)
Cell therapy product (ABMC) 93.6 (43.7–156.8) 0.8 (0.1–1.4) 0.36 (0.001–0.7) 
MEDIAN CMN (×106/ml)MEDIAN CD34+ (×106/ml)MEDIAN CD133+ (×106/ml)
Cell therapy product (ABMC) 93.6 (43.7–156.8) 0.8 (0.1–1.4) 0.36 (0.001–0.7) 
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PATIENTSTherapyPost-Treatmentp
Functional angina 3.2 ± 0.5 1.2 ± 0.5 <0.001 
N° pills/month 330 ± 118 175 ± 92 0.001 
Nitrates SL 22.1 ± 30.4 1.4 ± 1.3 0.02 
Hospital admissions 3.8 ± 1.9 0.5 ± 0.8 <0.001 
PATIENTSTherapyPost-Treatmentp
Functional angina 3.2 ± 0.5 1.2 ± 0.5 <0.001 
N° pills/month 330 ± 118 175 ± 92 0.001 
Nitrates SL 22.1 ± 30.4 1.4 ± 1.3 0.02 
Hospital admissions 3.8 ± 1.9 0.5 ± 0.8 <0.001 
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Disclosures:

Alegre:Celgene: Honoraria. Off Label Use: Lenalidomide is not approved for the treatment of smoldering multiple myeloma.

Topics:
bone marrow cells, coronary heart disease, transmyocardial revascularization by laser technique, angina pectoris, cell therapy, congenital melanocytic nevus, congenital mesoblastic nephroma, follow-up, surgical procedures, operative, anterior thoracotomy

Author notes

*

Asterisk with author names denotes non-ASH members.

© 2010 by The American Society of Hematology
2010
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