title: Granulocyte colony-stimulating factor-induced blood stem cell mobilisation in patients with chronic heart failure--Feasibility, safety and effects on exercise tolerance and cardiac function.
abstract: Bone marrow-derived stem cells may contribute to the regeneration of non-haematopoietic organs. In order to test whether an increase in circulating stem cell numbers improves impaired myocardial function we treated 16 male patients with chronic heart failure due to dilated (DCM; n = 7) or ischaemic cardiomyopathy (ICM; n = 9) with the stem cell mobilising cytokine granulocyte colony-stimulating factor (G-CSF; four 10-day treatment periods interrupted by treatment-free intervals of equal length). Safety and efficacy analyses were performed at regular intervals. Peak CD34+ cell counts remained constant from cycle to cycle. Cardiac side effects in ICM patients included occasional episodes of dyspnea or angina and one episode of fatal ventricular fibrillation. Nine (4 DCM, 5 ICM) of 12 patients receiving four full G-CSF cycles experienced an improvement by one New York Heart Association (NYHA) class and a statistically significant increase in six-minute walking distance. By contrast, none of 8 ICM historical controls had a change in NYHA class during a similar time period. Statistically significant changes in echocardiographic parameters were not recorded. Sequential administration of G-CSF is feasible and possibly effective in improving physical performance in patients with chronic heart failure. Patients with ICM may be at risk of increased angina and arrhythmias.
authors.affiliation: Klinik für Hämatologie, Universitätsklinikum Essen, Hufelandstrasse 55, 45122 Essen, Germany.
authors.forename: Andreas
authors.initials: A
authors.lastname: Hüttmann
authors.forename: Ulrich
authors.initials: U
authors.lastname: Dührsen
authors.forename: Jörg
authors.initials: J
authors.lastname: Stypmann
authors.forename: Richard
authors.initials: R
authors.lastname: Noppeney
authors.forename: Holger
authors.initials: H
authors.lastname: Nückel
authors.forename: Till
authors.initials: T
authors.lastname: Neumann
authors.forename: Achim
authors.initials: A
authors.lastname: Gutersohn
authors.forename: Sigrid
authors.initials: S
authors.lastname: Nikol
authors.forename: Raimund
authors.initials: R
authors.lastname: Erbel
mesh_terms: D000368:Aged; D005080:Exercise Test; D017079:Exercise Tolerance; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D006333:Heart Failure / Q000188:drug therapy*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007958:Leukocyte Count; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D016896:Treatment Outcome
chemical_list: D016179:Granulocyte Colony-Stimulating Factor