title: Granulocyte colony-stimulating factor improves the efficacy of autologous bone marrow-derived mononuclear cell transplantation treatment for lower limb ischemia.
abstract: BACKGROUND
  The safety and efficacy of autologous bone marrow-derived mononuclear cell (BM-MNC) transplantation in the treatment of lower limb ischemia is becoming established, although common treatment protocols are not yet agreed upon. We hypothesized that bone marrow mobilization with granulocyte colony-stimulating factor (G-CSF) improves the safety and effectiveness of cellular therapy.
  
  
  METHODS
  Forty-four patients were randomly assigned to receive two injections of G-CSF (300 µg) prior to BM-MNC transplantation. BM-MNC were harvested from all patients and injected as equal aliquots of at least 108 cells into the ischemic leg muscles below the lowest patent artery.
  
  
  RESULTS
  After 3 months, patients receiving G-CSF reported increased subjective relief of symptoms and showed increased transcutaneous oxygen tension (TcPO2). After 6 months, patients showed greater improvement in TcPO2, ankle-brachial index, and angiographic score compared to control patients. There were no increased numbers of side effects in patients receiving G-CSF.
  
  
  CONCLUSIONS
  G-CSF is safe and effective to mobilize BM-MNC and may allow reduced volume of aspirated bone marrow, potentially reducing procedural complications. G-CSF should be considered for use in patients that are candidates for angiogenic therapy. G-CSF may increase the number of patients that are candidates for therapeutic angiogenesis.
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China - guyq66@sina.com.|Institute of Vascular Surgery, Capital Medical University, Beijing, China - guyq66@sina.com.
authors.forename: Yongquan
authors.initials: Y
authors.lastname: Gu
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.|Institute of Vascular Surgery, Capital Medical University, Beijing, China.
authors.forename: Lianrui
authors.initials: L
authors.lastname: Guo
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.|Institute of Vascular Surgery, Capital Medical University, Beijing, China.
authors.forename: Jianming
authors.initials: J
authors.lastname: Guo
authors.affiliation: Interdepartmental Program in Vascular Biology and Therapeutics, Yale University School of Medicine, New Haven, CT, USA.
authors.forename: Alan
authors.initials: A
authors.lastname: Dardik
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.|Institute of Vascular Surgery, Capital Medical University, Beijing, China.
authors.forename: Shuwen
authors.initials: S
authors.lastname: Zhang
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.|Institute of Vascular Surgery, Capital Medical University, Beijing, China.
authors.forename: Zhu
authors.initials: Z
authors.lastname: Tong
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.|Institute of Vascular Surgery, Capital Medical University, Beijing, China.
authors.forename: Jian
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of Vascular Surgery, Xuanwu Hospital, Capital Medical University, Beijing, China.|Institute of Vascular Surgery, Capital Medical University, Beijing, China.
authors.forename: Zhonghao
authors.initials: Z
authors.lastname: Wang
mesh_terms: D000368:Aged; D000792:Angiography; D055109:Ankle Brachial Index; D001785:Blood Gas Monitoring, Transcutaneous; D016026:Bone Marrow Transplantation / Q000009:adverse effects / Q000379:methods*; D002681:China; D004334:Drug Administration Schedule; D005260:Female; D016179:Granulocyte Colony-Stimulating Factor / Q000008:administration & dosage* / Q000009:adverse effects; D019650:Hematopoietic Stem Cell Mobilization / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D007279:Injections, Subcutaneous; D007511:Ischemia / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D035002:Lower Extremity / Q000098:blood supply*; D008297:Male; D018919:Neovascularization, Physiologic; D058729:Peripheral Arterial Disease / Q000175:diagnosis / Q000503:physiopathology / Q000601:surgery*; D020127:Recovery of Function; D013997:Time Factors; D014182:Transplantation, Autologous; D016896:Treatment Outcome
chemical_list: D016179:Granulocyte Colony-Stimulating Factor