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.
Key Words
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Article info
Publication history
Published online: May 21, 2015
Accepted:
November 28,
2014
Received in revised form:
November 26,
2014
Received:
October 9,
2014
Footnotes
Z.-z.F. and H.-b.C. contributed equally to this work.
The authors have no conflict of interest to declare.
This study was supported by the Natural Science Foundation of Gansu Province (Grant No. 1107RJZA082).
Each author certifies that his or her institution approved or waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.
Identification
DOI: https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.11.033
Copyright
© 2015 National Stroke Association. Published by Elsevier Inc. All rights reserved.
