A phase 1 study to address the safety and efficacy of granulocyte colony-stimulating factor for the mobilization of hematopoietic progenitor cells in active rheumatoid arthritis.
OBJECTIVE
To examine the safety and efficacy of granulocyte colony-stimulating factor (G-CSF) alone for the mobilization of peripheral blood progenitor cells in patients with resistant active rheumatoid arthritis (RA).


METHODS
Five patients with resistant active RA were studied. A dose of 5 microg/kg of G-CSF (Filgrastim) was given subcutaneously each day for 5 days, and the number of stem cells mobilized into the peripheral blood was assessed by daily CD34 counts. RA disease activity was assessed by standard clinical methods.


RESULTS
The absolute numbers of peripheral blood CD34+ cells peaked on day 4, with a mean value of 0.025 x 10(9)/liter (range 0.013-0.048 x 10(9)/liter). There was no significant change in disease activity during the study or in the month following therapy.


CONCLUSIONS
Using G-CSF alone, CD34+ progenitor peripheral blood cells were mobilized in numbers suitable for leukopheresis. G-CSF therapy was well-tolerated in patients with active RA, and was not associated with a flare during treatment or in the month following treatment.
McGonagle
D
D
University of Leeds, UK.
Rawstron
A
A
Richards
S
S
Isaacs
J
J
Bird
H
H
Jack
A
A
Morgan
G
G
Emery
P
P
D000328:Adult; D000368:Aged; D018952:Antigens, CD34 / Q000032:analysis; D001172:Arthritis, Rheumatoid / Q000097:blood* / Q000503:physiopathology / Q000628:therapy*; D002097:C-Reactive Protein / Q000032:analysis; D002452:Cell Count; D002465:Cell Movement / Q000187:drug effects; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006412:Hematopoietic Stem Cells / Q000502:physiology*; D006801:Humans; D008875:Middle Aged; D009000:Monocytes / Q000276:immunology / Q000473:pathology; D010147:Pain Measurement; D012217:Rheumatoid Factor / Q000097:blood
D018952:Antigens, CD34; D016179:Granulocyte Colony-Stimulating Factor; D002097:C-Reactive Protein; D012217:Rheumatoid Factor