title: Granulocyte-colony stimulating factor therapy improves survival in patients with hepatitis B virus-associated acute-on-chronic liver failure.
abstract: OBJECTIVE
  To evaluate the safety and efficacy of granulocyte-colony stimulating factor (G-CSF) therapy in patients with hepatitis B virus (HBV)-associated acute-on-chronic liver failure (ACLF).
  
  
  METHODS
  Fifty-five patients with HBV-associated ACLF were randomized into two groups: the treatment group and the control group. Twenty-seven patients in the treatment group received G-CSF (5 μg/kg per day, six doses) treatment plus standard therapy, and 28 patients in the control group received standard therapy only. The peripheral CD34(+) cell count was measured consecutively by flow cytometry. Circulating white blood cell count, biochemical parameters, and other clinical data of these patients were recorded and analyzed. All patients were followed up for a period of 3 mo to evaluate the changes in liver function and survival rate.
  
  
  RESULTS
  The peripheral neutrophil and CD34(+) cell counts in the G-CSF group increased on day 3 from the onset of therapy, continued to rise on day 7, and remained elevated on day 15 compared to those of the control group. Child-Turcotte-Pugh score of patients in the treatment group was improved on day 30 from the onset of G-CSF therapy, compared to that in the controls (P = 0.041). Model for End-Stage of Liver Disease score of patients in the treatment group was improved on day 7 (P = 0.004) and remained high on day 30 from the onset of G-CSF therapy (P < 0.001) compared to that in controls. After 3 mo of follow-up observation, the survival rate in the treatment group (48.1%) was significantly higher than that in the control group (21.4%) (P = 0.0181).
  
  
  CONCLUSIONS
  G-CSF therapy promoted CD34(+) cell mobilization in patients with HBV-associated ACLF, and improved the liver function and the survival rate of these patients.
authors: Liver Failure Treatment and Research Center, Beijing 302 Hospital, Beijing 100039, China.
authors: Xue-Zhang
authors: XZ
authors: Duan
authors: Fang-Fang
authors: FF
authors: Liu
authors: Jing-Jing
authors: JJ
authors: Tong
authors: Hao-Zhen
authors: HZ
authors: Yang
authors: Jing
authors: J
authors: Chen
authors: Xiao-Yan
authors: XY
authors: Liu
authors: Yuan-Li
authors: YL
authors: Mao
authors: Shao-Jie
authors: SJ
authors: Xin
authors: Jin-Hua
authors: JH
authors: Hu
mesh_terms: D000328:Adult; D018952:Antigens, CD34 / Q000097:blood; D015415:Biomarkers / Q000097:blood; D049109:Cell Proliferation / Q000187:drug effects; D002633:Chemotaxis / Q000187:drug effects; D016009:Chi-Square Distribution; D002681:China; D004311:Double-Blind Method; D058625:End Stage Liver Disease / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000821:virology; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000009:adverse effects / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D006412:Hematopoietic Stem Cells / Q000187:drug effects / Q000276:immunology; D006509:Hepatitis B / Q000150:complications*; D006801:Humans; D008099:Liver / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism / Q000821:virology; D017114:Liver Failure, Acute / Q000097:blood / Q000188:drug therapy* / Q000276:immunology / Q000401:mortality / Q000821:virology; D008297:Male; D008875:Middle Aged; D009504:Neutrophils / Q000187:drug effects / Q000276:immunology; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018952:Antigens, CD34; D015415:Biomarkers; D016179:Granulocyte Colony-Stimulating Factor
keywords: Acute-on-chronic liver failure; Granulocyte-colony stimulating factor; Hepatitis B virus