The effect of CD34(+) cell telomere length and hTERT expression on the outcome of autologous CD34(+) cell transplantation in patients with chronic heart failure

摘要

Age-related telomere attrition in stem/progenitor cells may diminish their functional capacity and thereby impair the outcome of cell-based therapies. The aim of the present study was to investigate the effect of CD34(+) cell telomere length and hTERT expression on the clinical outcome of autologous CD34(+) cell transplantation. We studied 43 patients with cardiomyopathy. Their peripheral blood CD34(+) cells were mobilized with granulocyte colony-stimulating factor, enriched by immunoselection and delivered transendocardially. Relative telomere length and expression levels of hTERT were measured using a real-time PCR assay. Immunoselected CD34(+) cells had longer telomere length compared to leukocytes in leukapheresis products (p = 0.001). In multivariate analysis, CD34(+) cell telomere length was not associated with the clinical outcome (b = 3.306, p = 0.540). While hTERT expression was undetectable in all leukapheresis products, 94.4% of the CD34(+) enriched cell products expressed hTERT. Higher CD34(+) hTERT expression was associated with a better clinical outcome on univariate analysis (b = 87.911, p = 0.047). Our findings demonstrate that CD34(+) cell telomere length may not influence the clinical outcome in cardiomyopathy patients treated with autologous CD34(+) cell transplantation. Larger studies are needed to validate the impact of the CD34(+) hTERT expression on the clinical outcome of autologous CD34(+) cell transplantation.