The effect of long-term treatment with granulocyte colony-stimulating factor on hematopoiesis in HIV-infected individuals.
This randomized, placebo-controlled trial examine the long-term effect of granulocyte colony-stimulating factor (G-CSF) on absolute numbers of CD34+ progenitor cells and progenitor cell function in human immunodeficiency virus (HIV)-infected patients. G-CSF (300 microg filgrastim) or placebo was given three times weekly for 12 weeks to 30 HIV-infected patients that had been treated with HAART for at least 24 weeks and not yet achieved CD4 counts above 350 CD4+ cells/microl. Blood samples were collected at weeks 0, 2, 4, 8, and 12, and again 12 weeks after termination of the G-CSF treatment. Significant increase in absolute numbers of circulating CD34+ cells was detected in the treatment group (P = 0.006). The function of progenitor cells was examined in vitro using a colony-forming unit (CFU) assay, and increase in the number of CFU/ml was detected (P = 0.005). In order to estimate the effect of G-CSF on in vivo function of progenitors the white-blood count was determined. Significant increase in white-blood count was found (P < 0.001), while hemoglobin and platelet count decreased (P = 0.001 and P = 0.013, respectively). Significant increase in the CD4 count occurred, but correlation between the numbers of progenitors and the CD4 count was not found. These data suggest that G-CSF mainly increases the number and differentiation of myeloid progenitors.
Nielsen
S D
SD
Department of Infectious Diseases, 144, Hvidovre Hospital, 2650 Hvidovre, Denmark. sdn@dadlnet.dk
Sørensen
T U
TU
Aladdin
H
H
Ersbøll
A K
AK
Mathiesen
L
L
Ullum
H
H
Gerstoft
J
J
Nielsen
J O
JO
Pedersen
B K
BK
D019380:Anti-HIV Agents / Q000627:therapeutic use; D001772:Blood Cell Count / Q000187:drug effects*; D018791:CD4 Lymphocyte Count / Q000187:drug effects; D002454:Cell Differentiation / Q000187:drug effects; D005260:Female; D000069585:Filgrastim; D016179:Granulocyte Colony-Stimulating Factor / Q000494:pharmacology* / Q000627:therapeutic use; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy / Q000503:physiopathology*; D006410:Hematopoiesis / Q000187:drug effects*; D019650:Hematopoietic Stem Cell Mobilization; D006454:Hemoglobins / Q000032:analysis; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D009503:Neutropenia / Q000188:drug therapy* / Q000209:etiology; D010976:Platelet Count / Q000187:drug effects; D011994:Recombinant Proteins; D013997:Time Factors
D019380:Anti-HIV Agents; D006454:Hemoglobins; D011994:Recombinant Proteins; D016179:Granulocyte Colony-Stimulating Factor; D000069585:Filgrastim