Abstract
Background aims. Stem cells, namely easily accessible bone marrow-derived cells (BMC), are reportedly capable of tissue repair in different damaged organs and might favor wound healing. The present study was undertaken to evaluate the feasibility and safety of BMC mobilization induced by granulocyte–colony-stimulating factor (G-CSF) in patients undergoing surgery for sacrococcygeal pilonidal cysts (SPC). To evaluate the possible clinical benefit of G-CSF in reducing the time to complete resolution, a comparison with a control group receiving surgery without G-CSF was performed. Methods. Eight patients with complex SPC were included in this prospective trial. Patients were treated with G-CSF (5 µg/kg b.i.d.) for 3 consecutive days; standard surgical exeresis of the pilonidal cyst was scheduled on day 2 of mobilization. Mobilization was assessed in terms of circulating CD34+ cells and granulocyte–macrophage colony-forming unit (CFU-GM) progenitors. Results. Mobilization of CD34+ cells and CFU-GM occurred in all patients, along with a marked increase in white blood cells (median peak value 28 435/µL, day 3). G-CSF was well tolerated and no adverse events occurred. All patients received the planned surgical treatment without any complications. Interestingly, the G-CSF group patients had a median time to resolution (117 days, range 110–130) significantly shorter than control patients (145 days, range 118–168) (P = 0.034). Conclusions. G-CSF administration, along with BMC mobilization, is feasible and well tolerated in patients undergoing surgery for SPC; clinical results compare favorably with those observed in controls not receiving G-CSF; the results suggest the potential use of G-CSF as an additional treatment to accelerate wound healing in patients undergoing surgery.
Acknowledgments
This work was supported in part by grants from the Ministero Italiano Università e Ricerca (MIUR) (PRIN 2006 and Ricerca locale), Rome, Italy, and Regione Piemonte (Ricerca Sanitaria Finalizzata and Ricerca Scientifica Applicata), Torino, Italy and by A.I.R.C. (Associazione Italiana per la Ricerca sul Cancro). G-CSF Lenograstim (rHu G-CSF) (Myelostim®, Italfarmaco) was kindly provided by Azienda Ospedaliero–Universitaria San Giovanni Battista of Torino.
Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.