Consider The Evidence: Med/Peds Journal Roundup

March 30, 2006

Dont count out G-CSF just yet….

Filed under: CMAJ, stem cells, stroke — medblog @ 5:15 pm

CMAJ 3/28 – Well it didnt work for the heart, but can it work in the brain? G-CSF is a promising treatment for the regeneration of infarcted tissues, due to its trophic and chemotactic effects on stem cells. However, in a JAMA article covered earlier this year, the treatment failed to improve outcomes in MI.

This month, Shyu et al. present a phase I study of such treatment for improving stroke outcomes. Although there appeared to be some benefit, the teeny-tiny (n=10) size of the trial precludes any major conclusions. It seems promising, however, that the group treated early with G-CSF achieved higher stroke-scale scores that the ususal care group. The study did also affirm the safety and feasability of the treatment (as is the point of phase I trials). Larger phase II trials are in the works that will hopefully show conclusively that G-CSF can be neuroprotective as well as stimulate new neuron production.

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February 28, 2006

G-CSF can’t stem the tide of Acute MI

Filed under: Cardiology, JAMA, myocardial infarction, stem cells — medblog @ 10:45 pm

JAMA 3/1 – Disappointing results from Zohlnhofer et al. in this weeks’ JAMA from a trial utilizing G-CSF to mobilize stem cells after acute MI (free full text avail.) Although some preliminary studies were promising, this is the first true RCT to address the subject. The researchers administered G-CSF 5 days after infarct and then followed up patients with T-99 scintigraphy, MRI, and/or angio. Although a significant increase of CD34+ cells was detected, indicating a surge of stem cells was mobilized – there was no significant difference in LVEF or infarct size at follow up. . . (more…)

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