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Stem cell mobilization and collection in patients with liver cirrhosis
Author(s) -
LORENZINI S.,
ISIDORI A.,
CATANI L.,
GRAMENZI A.,
TALARICO S.,
BONIFAZI F.,
GIUDICE V.,
CONTE R.,
BACCARANI M.,
BERNARDI M.,
FORBES S. J.,
LEMOLI R. M.,
ANDREONE P.
Publication year - 2008
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/j.1365-2036.2008.03670.x
Subject(s) - leukapheresis , medicine , cirrhosis , granulocyte colony stimulating factor , stem cell , bone marrow , cd34 , liver function , immunology , gastroenterology , chemotherapy , biology , genetics
Summary Background Bone marrow‐derived stem cells (BMSC) and granulocyte colony‐stimulating factor (G‐CSF) have been proved to contribute to tissue regeneration after liver injury. Aims To test the safety of G‐CSF and define the exact dose capable of mobilizing BMSC in the majority of patients with liver cirrhosis; and to assess the feasibility of leukapheresis to collect BMSC from peripheral blood. Methods In this study, we treated 18 patients affected by liver cirrhosis with increasing doses of G‐CSF to mobilize CD34 + and CD133 + BMSC into the peripheral blood. Results The dose‐finding phase demonstrated that 15 μg/kg/day of G‐CSF is the optimal dose to mobilize both CD34 + and CD133 + stem cells. Circulating BMSC were collected by a single step leukapheresis in three patients and the mean number of CD34 + and CD133 + cells cryopreserved was 1.3 ± 0.7 and 1.2 ± 0.5 × 10 6 /kg, respectively. No severe adverse events were observed during the drug administration and stem cell collection. Noteworthy is, none of the patients showed a significant modification of liver function. Conclusions Our study demonstrates that G‐CSF administration and BMSC collection from the peripheral blood is possible and safe in patients with liver cirrhosis. The optimal dose to mobilize BMSC in cirrhotics is 15 μg/kg/day. At this dose, G‐CSF does not seem to modify the residual liver function in cirrhotic patients.