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International Angiology 2017 August;36(4):346-53

DOI: 10.23736/S0392-9590.16.03796-2


lingua: Inglese

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

Yongquan GU 1, 2 , Lianrui GUO 1, 2, Jianming GUO 1, 2, Alan DARDIK 3, Shuwen ZHANG 1, 2, Zhu TONG 1, 2, Jian ZHANG 1, 2, Zhonghao WANG 1, 2

1 Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China; 2 Institute of Vascular Surgery, Capital Medical University, Beijing, China; 3 Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine, New Haven, CT, USA


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.

KEY WORDS: Granulocyte colony-stimulating factor - Bone marrow - Ischemia

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