title: Stem cell mobilization and collection in patients with liver cirrhosis.
abstract: BACKGROUND
  Bone marrow-derived stem cells (BMSC) and granulocyte colony-stimulating factor (G-CSF) have been proved to contribute to tissue regeneration after liver injury.
  
  
  OBJECTIVE
  To test the safety of G-CSF and define the exact dose capable of mobilizing BMSC in the majority of patients with liver cirrhosis; and to assess the feasibility of leukapheresis to collect BMSC from peripheral blood.
  
  
  METHODS
  In this study, we treated 18 patients affected by liver cirrhosis with increasing doses of G-CSF to mobilize CD34(+) and CD133(+) BMSC into the peripheral blood.
  
  
  RESULTS
  The dose-finding phase demonstrated that 15 microg/kg/day of G-CSF is the optimal dose to mobilize both CD34(+) and CD133(+) stem cells. Circulating BMSC were collected by a single step leukapheresis in three patients and the mean number of CD34(+) and CD133(+) cells cryopreserved was 1.3 +/- 0.7 and 1.2 +/- 0.5 x 10(6)/kg, respectively. No severe adverse events were observed during the drug administration and stem cell collection. Noteworthy is, none of the patients showed a significant modification of liver function.
  
  
  CONCLUSIONS
  Our study demonstrates that G-CSF administration and BMSC collection from the peripheral blood is possible and safe in patients with liver cirrhosis. The optimal dose to mobilize BMSC in cirrhotics is 15 microg/kg/day. At this dose, G-CSF does not seem to modify the residual liver function in cirrhotic patients.
authors.affiliation: Department of Internal Medicine, Cardioangiology and Hepatology, University of Bologna, Bologna, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Lorenzini
authors.forename: A
authors.initials: A
authors.lastname: Isidori
authors.forename: L
authors.initials: L
authors.lastname: Catani
authors.forename: A
authors.initials: A
authors.lastname: Gramenzi
authors.forename: S
authors.initials: S
authors.lastname: Talarico
authors.forename: F
authors.initials: F
authors.lastname: Bonifazi
authors.forename: V
authors.initials: V
authors.lastname: Giudice
authors.forename: R
authors.initials: R
authors.lastname: Conte
authors.forename: M
authors.initials: M
authors.lastname: Baccarani
authors.forename: M
authors.initials: M
authors.lastname: Bernardi
authors.forename: S J
authors.initials: SJ
authors.lastname: Forbes
authors.forename: R M
authors.initials: RM
authors.lastname: Lemoli
authors.forename: P
authors.initials: P
authors.lastname: Andreone
mesh_terms: D000071916:AC133 Antigen; D000328:Adult; D000368:Aged; D015703:Antigens, CD; D018952:Antigens, CD34; D004305:Dose-Response Relationship, Drug; D005240:Feasibility Studies; D005260:Female; D006023:Glycoproteins; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D006801:Humans; D007937:Leukapheresis / Q000379:methods*; D008103:Liver Cirrhosis / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010455:Peptides; D036102:Peripheral Blood Stem Cell Transplantation / Q000379:methods*; D016896:Treatment Outcome
chemical_list: D000071916:AC133 Antigen; D015703:Antigens, CD; D018952:Antigens, CD34; D006023:Glycoproteins; C000606023:PROM1 protein, human; D010455:Peptides; D016179:Granulocyte Colony-Stimulating Factor