Publication Date:
2005-11-16
Description:
Granulocyte-Colony stimulating factor (G-CSF) is widely used in the treatment of hematological malignancies. The administration of G-CSF is a novel therapy for ischemic heart disease (IHD), but current data are controversial and the safety and efficacy of G-CSF in acute or chronic IHD is unclear. Aim: to assess safety and efficacy of G-CSF administration and stem cell mobilization in patients with chronic refractory ‘no option’ IHD. Methods: After baseline cardiac assessment (CA) [Seattle Angina Questionnaire (SAQ), Bruce exercise stress test (EST), persantin-Sestamibi and dobutamine-echocardiographic imaging], stable ‘no option’ IHD patients received open-label G-CSF 10μg/kg for 5 days, with an EST (to facilitate myocardial cytokine generation and stem cell trafficking) on the 4th and 6th days. After 3 months, CA and the same regimen of G-CSF and ESTs was repeated, but in addition, leucopheresis and a randomized double-blinded intracoronary infusion of either CD133+ or unselected cells was performed (randomized data remains blinded). Final CA was 3 months thereafter. Results: Thirteen patients (12 male, 1 female, mean age 62) received 21 cycles of G-CSF. There were no deaths, Q-wave AMIs or any complications with long-term sequelae, although, transient troponin-I elevation (n = 3) and thrombocytopenia (n = 2) were observed. Mean CD133+ cell count rose from 1.28 to 56.12 x1012/L (p = 0.001). There was no age-related trend towards lower numbers of G-CSF mobilized CD34+ cells in the IHD patients, as compared to a group of younger (
Print ISSN:
0006-4971
Electronic ISSN:
1528-0020
Topics:
Biology
,
Medicine
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