To evaluate therapeutic efficacy of mesenchymal stem cells in patients with severe acute pancreatitis.

To determine the efficiency of maintenance therapy with bortezomib in patients with multiple myeloma (MM) who have achieved complete remission (CR) after autologous hematopoietic stem cell (auto-HSCT), depending on the presence of minimal residual disease (MRD).

To determine place of vitamin D in prevention and treatment of cardiorenal syndrome (CRS) and chronic allograft nephropathy (CAN) in the aspect of myocardial and renal reparation.

Presented herein are the outcomes of using autologous progenitor cells of the bone marrow in a total offorty-two male patients suffering from atherosclerosis obliterans of the lower-limb arteries with degree II B of ischaemia according to the classification of A. V. Pokrovsky, preconditioned by involvement of the femoropopliteal-tibial segment with no possibility to perform a reconstructive operation. It was a randomized, double-blind, placebo-controlled study limited by a clinical approbation of the method concerned. Bone marrow was sampled from the crests of the iffac bone. Exflisate was subjected to double centrifugation to obtain the leukocytic fraction of the bone marrow, immune magnetic separation--for obtaining the CD 133+ cells. The patients were subdivided into three groups, each consisting of 14 subjects. Group One patients received autologous progenitor cells CD133+, Group Two patients were given the leukocytic fraction of the marrow (CD34+), and Group Three patients (comparison group) received normal saline as aplacebo. The preparations were administered into the muscles of the internal and external surface of the crus. The clinical outcomes were evaluated according to the Rutherford scale and demonstrated that Group One and Group Two patients given the cellular material exhibited a statistically significant improvement of their clinical condition, as compared with the findings obtained in the placebo group (P < 0.001, by the Mann-Witney test). Based on the results of the treadmill tests performed after 1, 6 and 12 months, the distance of pain-free walk was noted to statistically significantly increase in Group One and Group Two patients, as compared with those from the placebo group. The proposed method of treatment may be recommended for multicenter clinical trials.

We present our own experience of assessment of effect of cell therapy on functional state of the myocardium in patients with lowered contractile capacity of the left ventricular myocardium. Intracoronary administration of stem cells in acute myocardial infarction is a safe method of treatment. It does not cause additional damage of the myocardium and does not provoke appearance of malignant arrhythmia. Cell therapy does not affect global left ventricular function. Data we have obtained demonstrate tendency to improvement of myocardial contractile function in dynamics in the majority of studied patients, including patients of the comparison group. This most probably indicates that the given process has been caused by restoration of blood flow to surviving cardiomyocytes after transluminal coronary angioplasty and improvement of function. Confirmation of participation of administered cells in myocardial contraction and improvement of perfusion requires further clinical investigations.

Mobilization of bone marrow stem cells by granulocyte-colony-stimulating factor (G-CSF) is considered to be an alternative to invasive transplantation of autologous myoblasts or stem cells directly into injured cardiac tissue. We have started a 24 week randomized open study in order to elucidate effects of G-CSF (filgrastim) on clinical, hemodynamic and neurohumoral status of patients with NYHA class II-IV chronic heart failure due to ischemic heart disease with zones of nonviable myocardium and left ventricular ejection fraction <40% as well as to assess safety of addition of G-CSF to standard therapy with ACE inhibitors and beta-blockers. It is planned to include 20 patients into each filgrastim (5 mg/kg/day) and control (0.9% NaCl) groups. Methods to be used: dobutamine stress echocardiography for detection of myocardial viability, magnetic resonance tomography, 6-minute walk test, quality of life questionnaire. By the present time 5 patients were included (4 in filgrastim and 1 in control group) and passed 3-6 months points. A control patient died suddenly on 11th week. All patients in filgrastim group are alive (1 experienced obvious improvement, 2 remained stable, and 1 deteriorated and required urgent hospitalization). None of the patients had signs of appearance of 'regenerated' myocardial zones. The patient with positive clinical dynamics was characterized by young age (48 years), moderately severe heart failure (NYHA class II) and pronounced leukocyte reaction to filgrastim (12 fold increase in white blood cell count with appearance of myelocytes and myeloblasts ). In contrast patients without improvement were older than 60 years, had NYHA class III heart failure and experienced just 6-8 fold increases in leukocyte count. These factors are suggested to be predictors of clinical efficacy of G-CSF in patients with heart failure.