Peripheral blood stem cell mobilisation by granulocyte-colony stimulating factor in patients with acute and old myocardial infarction for intracoronary cell infusion

Abstract

Background/aims: Peripheral blood stem cells (PBSC) are one of the most promising stem cell sources for treatment of ischaemic heart disease. However, the experience of mobilisation and collection of PBSC using granulocyte-colony stimulating factor (G-CSF) in patients with myocardial infarction (MI) is still limited. We report our experiences with the feasibility and safety of collection of mobilised PBSC with G-CSF in MI patients, and the influence of acute ischaemia on efficacy of PBSC collection. Methods: 74 patients with acute or old myocardial infarction (AMI vs OMI, n = 46 and n = 28) underwent PBSC collection after administration of G-CSF twice a day at a dose of 5 mg/kg for 3 days. Flow cytometric analysis of cell surface markers was performed. Results: No evidence of inflammation or ischaemia was observed during G-CSF mobilisation and PBSC collection. The yield of CD34(+) cells was 12.9 (SD 15.92) X10(9)/l (5.04% (5.30%) of total cells) with a product volume of 37.9 (8.4) ml after 5650 (987) ml of blood were processed during PBSC collection. Stem cell mobilisation and collection by G-CSF is more efficient in AMI than in OMI, and proportions of cells positive for VE-cadherin or KDR/CD34 are significantly greater in AMI than in OMI (p<0.01). Conclusion: We could obtain sufficient numbers of PBSC for intracoronary infusion with the G-CSF-based mobilisation strategy without complications even in patients with MI. PBSC collection after mobilisation with G-CSF is a safe and feasible method of stem cell collection for therapeutic purpose in patients with MI.