Mobilization And Safety Of Peripheral Blood Stem Cells In Patients With Acute Myocardial Infarction

Objective To investigate the mobilization and safety of CD34-positive mononuclear cells(MNC^CD34+) in the peripheral blood of the patients with acute myocardial infarction(AMI).Method To examine the quantity of the MNC^CD34+ through Flow cytomery at different times after AMI. In the mean time, to examine the plasma level of granulocyte colony-stimulating factor, (G-CSF) , basic fibroblast growth factor(bFGF), granulocyte macrophagecolony-stimulating factor(GM-CSF), interleukin-3(IL-3), interleukin-8 (IL-8) by ELISA. 22 patients with AMI were randomly allocated to receive the dose of inclusive type G-CSF 300ug/day by hypodermic injection and the duration was 5 days. The following side effects had been attended including bone pain, tetter, fever, gastrointestinal effects, deteriorated of angina or heart failure and some rare effects such as spontaneous spleen rupture, severe purulent infection, hypercoagulable state and autologous immune disease.Results MNC^CD34+ increased after the onset of AMI and peaked on day 7, then gradually decreased, but the number on day 28 was still greater than that on day 1. In controls, circulating MNC^CD34+ counts on days 1 and 7 were similar. The MNC^CD34+ counts did not differ between the AMI and control groups on day 1, but they were significantly greater in the AMI group than in the control group on day 7(P<0.001).In the five cytokines only plasma G-CSF levels were significantly elevated, peaking on day 7; the levels of the other 4 cytokines were unchanged. G-CSF levels slightly but significantly increased on day 7 compared with day 1 in the control group. However, on day 7, plasma G-CSF levels were significantly greater in the AMI group than in the control group. We examined the potential relationship between MNC^CD34+ counts and plasma cytokine levels in AMI. Simple regression analysis revealed that the number of circulating MNC^CD34+ positively correlated with the plasma levels of G-CSF.( r=0.379, p<0.01). There were total 10 cases with complications during the mobilization , including bone pain 18.2% (4/22) , fever 13.6% (3/22) .tetter 4.5% (1/22) , deterioration of heart failure 4.5% (1/22) , pale 4.5% (1/22) .Conclusion The quantity of MNC^CD34+ and G-CSF in the peripheral blood of patients With AMI is higher than the healthy people. Maybe G-CSF correlate with the mobilization. In patients with AMI, the mobilization of peripheral blood stem cells by G-CSF is safe and feasible.