title: The Efficacy and Safety of Granulocyte Colony-Stimulating Factor for Patients with Stroke.
abstract: BACKGROUND
  Granulocyte colony-stimulating factor (G-CSF) has been shown to reduce lesion volume and improve functional outcome in experimental stroke models. However, whether G-CSF plays a role currently in patients with stroke remains uncertain. Our study aimed at examining the efficacy and safety of G-CSF in patients with acute ischemic stroke.
  
  
  METHODS
  A comprehensive search was conducted in 5 online databases up to April 2014, and 10 studies with 711 patients met the criteria.
  
  
  RESULTS
  The results showed that G-CSF was beneficial in improving the National Institutes of Health Stroke Scale (standardized mean difference [SMD], .43; 95% confidence interval [CI], .03-.82; P = .04) and modified Rankin Scale (mRS) scores (SMD, .72; 95% CI, .51-.93; P = .01), and elevating CD34(+) count (P < .001). No treatment effects were found in Barthel Index scores (SMD, -.13; 95% CI, -.61 to .35; P = .59), serious adverse events (relative ratio [RR], 1.12; 95% CI, .91-1.38; P = .28), or the death of serious adverse events (RR, 1.25; 95% CI, .82-1.91; P = .30) between groups at day 90. Adverse effect on vascular complications was not detected to be increased although G-CSF produced a marked elevation in the total leukocyte count (SMD, 3.52; 95% CI, 2.54-4.49; P < .001).
  
  
  CONCLUSIONS
  In conclusion, G-CSF is effective at mobilizing bone marrow-derived CD34(+) stem cells to the peripheral blood. It also seems to improve the National Institutes of Health Stroke Scale and mRS scores. The administration of G-CSF appears to be safe and well tolerated. Further studies need to be done on a large sample to verify or fully characterize the results.
authors.affiliation: Department of Neurology, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Zhen-Zhen
authors.initials: ZZ
authors.lastname: Fan
authors.affiliation: Department of Neurology, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Hong-Bin
authors.initials: HB
authors.lastname: Cai
authors.affiliation: Department of Neurology, Second Hospital of Lanzhou University, Lanzhou, China. Electronic address: gezhaoming@163.com.
authors.forename: Zhao-Ming
authors.initials: ZM
authors.lastname: Ge
authors.affiliation: Department of Neurology, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Li-Qun
authors.initials: LQ
authors.lastname: Wang
authors.affiliation: Department of Neurology, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Xu-Dong
authors.initials: XD
authors.lastname: Zhang
authors.affiliation: Department of Psychiatry, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Li
authors.affiliation: Department of Neurology, Second Hospital of Lanzhou University, Lanzhou, China.
authors.forename: Xiao-Bin
authors.initials: XB
authors.lastname: Zhai
mesh_terms: D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D020521:Stroke / Q000188:drug therapy*
chemical_list: D016179:Granulocyte Colony-Stimulating Factor
keywords: Stroke; granulocyte colony-stimulating factor (G-CSF); hematopoietic stem cell; meta-analysis