Mononucleate da sangue periferico autologhe da filtrazione selettiva per il trattamento delle lesioni croniche dell’arto inferiore: Risultati a 4 anni

  • Matteo Bucalossi | matteobucalossi@tiscali.it The Compression Therapy Study Group (CTG), Firenze; Unità Operativa Chirurgia, Valdisieve Hospital, Pontassieve (FI); European Training Centre in Phlebology-European Union of Medical Specialists UEMS, Angiomedica Vein Clinic, Colle Val d’Elsa-Siena, Italia.
  • Fabrizio Mariani The Compression Therapy Study Group (CTG), Firenze; Unità Operativa Chirurgia, Valdisieve Hospital, Pontassieve (FI); European Training Centre in Phlebology-European Union of Medical Specialists UEMS, Angiomedica Vein Clinic, Colle Val d’Elsa-Siena, Italia.

Abstract

Recentemente è stato introdotto sul mercato una tecnologia a filtrazione selettiva per produrre un concentrato autologo di cellule mononucleate da sangue periferico (Peripheral Blood Mononuclear Cells, PBMNC) con indicazione d’uso per terapia cellulare umana. Le PBMNC trovano indicazione nel trattamento delle lesioni croniche degli arti inferiori. Lo scopo di questo studio è quello di valutare l’efficacia e la tollerabilità di tale trattamento in un gruppo di pazienti che presentavano ulcere cutanee degli arti inferiori, ad etiologia varia, non rispondono alle terapie topiche tradizionali ed avanzate. Lo studio è prospettico standardizzato. Sono state trattati 8 pazienti che presentavano in totale 22 ulcere cutanee ad etiologia variabile. Le PBMNC autologhe sono state impiantate lungo il decorso delle arterie tibiali di riferimento e nell’area peri-lesionale. Tutti i pazienti sono stati sottoposti ad un ciclo di tre infiltrazioni, eseguite in sala operatoria, con cadenza mensile, tranne un paziente che è stato sottoposto ad un quarto impianto, perché l’operatore ha ritenuto che uno ulteriore avrebbe accelerato lo stato già rigenerativo della cute stessa. Delle 22 ulcere trattate con tale metodologia, 14 sono giunte a guarigione completa entro un mese dalla fine dei tre impianti, mentre 8 sono andate verso un netto miglioramento. Tutti i pazienti hanno mostrato una buona compliance al trattamento e non sono stati registrati effetti avversi minori o maggiori. Il 50% dei pazienti trattati è stato sottoposto a follow-up a quattro anni dalla fine del trattamento, e solo una paziente ha avuto un’ulcera cutanea recidiva, ma in altra sede da quella iniziale. Le PBMNC, prodotte con sistema a filtrazione selettiva, si sono dimostrate un trattamento efficace delle lesioni croniche a diversa eziologia degli arti inferiori. La guarigione di tutte le lesioni cutanee trattate in tempi rapidi, la netta riduzione del dolore, e l’assenza di recidive a quattro anni suggeriscono un effetto clinico duraturo nel tempo.

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Pubblicato
2021-07-30
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Mononucleate da sangue periferico (PBMNC), lesioni croniche arti inferiori, filtrazione selettiva, recidiva
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Come citare
Bucalossi, M., & Mariani, F. (2021). Mononucleate da sangue periferico autologhe da filtrazione selettiva per il trattamento delle lesioni croniche dell’arto inferiore: Risultati a 4 anni. Italian Journal of Wound Care, 5(2). https://doi.org/10.4081/ijwc.2021.69