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Int Angiol. 2017 Aug;36(4):346-353. doi: 10.23736/S0392-9590.16.03796-2. Epub 2016 Dec 13.

Granulocyte colony-stimulating factor improves the efficacy of autologous bone marrow-derived mononuclear cell transplantation treatment for lower limb ischemia.

Gu Y1,2, Guo L3,4, Guo J3,4, Dardik A5, Zhang S3,4, Tong Z3,4, Zhang J3,4, Wang Z3,4.

Author information

1
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China - guyq66@sina.com.
2
Institute of Vascular Surgery, Capital Medical University, Beijing, China - guyq66@sina.com.
3
Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.
4
Institute of Vascular Surgery, Capital Medical University, Beijing, China.
5
Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine, New Haven, CT, USA.

Abstract

BACKGROUND:

The safety and efficacy of autologous bone marrow-derived mononuclear cell (BM-MNC) transplantation in the treatment of lower limb ischemia is becoming established, although common treatment protocols are not yet agreed upon. We hypothesized that bone marrow mobilization with granulocyte colony-stimulating factor (G-CSF) improves the safety and effectiveness of cellular therapy.

METHODS:

Forty-four patients were randomly assigned to receive two injections of G-CSF (300 µg) prior to BM-MNC transplantation. BM-MNC were harvested from all patients and injected as equal aliquots of at least 108 cells into the ischemic leg muscles below the lowest patent artery.

RESULTS:

After 3 months, patients receiving G-CSF reported increased subjective relief of symptoms and showed increased transcutaneous oxygen tension (TcPO2). After 6 months, patients showed greater improvement in TcPO2, ankle-brachial index, and angiographic score compared to control patients. There were no increased numbers of side effects in patients receiving G-CSF.

CONCLUSIONS:

G-CSF is safe and effective to mobilize BM-MNC and may allow reduced volume of aspirated bone marrow, potentially reducing procedural complications. G-CSF should be considered for use in patients that are candidates for angiogenic therapy. G-CSF may increase the number of patients that are candidates for therapeutic angiogenesis.

PMID:
27958690
DOI:
10.23736/S0392-9590.16.03796-2
[Indexed for MEDLINE]

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