Prognosis after autologous peripheral blood stem cell transplantation for osteonecrosis of the femoral head in the pre-collapse stage: a retrospective cohort study

Autor: Di Chen, Peijian Tong, Quanwei Ding, Jiafei Pan, Shuaijie Lv, Hongting Jin, Bingjiang Xia, Luwei Xiao
Rok vydání: 2019
Předmět:
0301 basic medicine
Adult
Male
medicine.medical_specialty
Medicine (miscellaneous)
Proportional hazards model
Lower risk
Biochemistry
Genetics and Molecular Biology (miscellaneous)
lcsh:Biochemistry
Cohort Studies
03 medical and health sciences
Femoral head
0302 clinical medicine
Femoral head survival
Femur Head Necrosis
Internal medicine
medicine
Humans
lcsh:QD415-436
Longitudinal Studies
Retrospective Studies
030222 orthopedics
lcsh:R5-920
Peripheral Blood Stem Cell Transplantation
business.industry
Research
Hazard ratio
Retrospective cohort study
Cell Biology
Nomogram
Transplantation
030104 developmental biology
medicine.anatomical_structure
Treatment Outcome
Harris Hip Score
Peripheral Blood Stem Cells
Molecular Medicine
Female
business
lcsh:Medicine (General)
Peripheral blood stem cell
Zdroj: Stem Cell Research & Therapy
Stem Cell Research & Therapy, Vol 11, Iss 1, Pp 1-9 (2020)
ISSN: 1757-6512
Popis: Objectives Autologous peripheral blood stem cell (auto-PBSC) transplantation is an effective therapeutic for the osteonecrosis of the femoral head (ONFH) but without prognosis estimation. This study mainly aimed to (1) determine whether auto-PBSC transplantation is a promising option, (2) assess the risk of hip-preservation failure, (3) achieve a predictive model of femoral head survival after the intervention, and (4) eventually identify clinical indications for auto-PBSC transplantation in future. Methods After reviewing the in-patient database of the First Affiliated Hospital of Zhejiang Chinese Medicine University from June 2012 to June 2014, 37 eligible patients with Association Research Circulation Osseous stage I or II ONFH who were receiving intra-arterial infusion of auto-PBSCs were recruited. A case form was designed to retrieve relevant data. Hip-preservation failure was defined as the endpoint. All participants were stratified by the categorical risk of collapse, which was statistically tested through log-rank analysis. All significant factors were evaluated using Cox proportional hazards regression model, and a predictive nomogram plot was generated. Results In total, 47 hips were followed up for 53.96 ± 21.09 months; the median survival time was 60.18 months. Among the predictors, body mass index (BMI; P = 0.0015) and Harris hip score (HHS; P 2 exhibited a 2.58 times higher risk of hip-preservation failure [95% confidence interval (CI), 1.32–5.45] than those with BMI 2, whereas those with HHS ≥ 70 exhibited a 0.19 times lower risk (95% CI, 0.09–0.38) than those with HHS P = 0.042), BMI (P = 0.012), HHS (P = 0.022), and necrotic volume (P = 0.000) were 1.038 (95% CI, 1.001–1.075), 1.379 (95% CI, 1.072–1.773), 0.961 (95% CI, 0.928–0.994), and 1.258 (95% CI, 1.120–1.412), respectively. A nomogram plot (score test P = 0.000; C-index = 0.8863) was available for the orthopedic doctor to predict hip survival probability. Conclusions The results suggest that intra-arterial infusion of auto-PBSCs prolongs femoral head survival. Age, BMI, HHS, and necrotic volume can influence the efficacy of this intervention. This study was approved by ethics committee of the trial center, number 2019-KL-075-01.
Databáze: OpenAIRE
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