Autologous bone marrow stem cell mobilization induced by granulocyte colony-stimulating factor after myocardial infarction

Abstract

Nine randomized controlled studies have so far evaluated the safety and efficacy profile Granulocyte-colony stimulating factor (G-CSF) in the setting of the acute/subacute phase of myocardial infarction (MI) in humans on a total of 409 patients. The drug, administered at various regimen, ranging from 2.5 to 10 mg/kg for a minimum of 4 to a maximum of 6 days, has been well tolerated. In one single prematurely stopped study (MAGIC), safety concerns were raised by an unexpected high restenosis rate in stented vessel. This was not confirmed in all subsequent studies. A clear improvement in the treated vs. control group at follow-up in left ventricular (LV) function/remodelling indexes has been reported in two studies (FIRST-LINE and RIGENERA). In a third investigation, LV ejection fraction improved in the treated but not in the control group with respect to baseline, but no significant difference emerged between G-CAF and placebo group at follow-up (Takano et al.). In all other six studies, no clear effect of treatment was noted. Future properly powered randomized controlled studies ideally targeting patients with large anterior MI with poor response to early reperfusion are warranted to further clarify the role of G-CSF in this setting. © The Author 2008.