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(Stroke. 2007;38:1997.)
© 2007 American Heart Association, Inc.

Cochrane Corner

Colony Stimulating Factors (Blood Growth Factors) Are Promising but Unproven for Treating Stroke

From the Division of Stroke Medicine, University of Nottingham, Nottingham, UK.

Correspondence to Philip M.W. Bath, Division of Stroke Medicine, University of Nottingham, Nottingham City campus, Nottingham, United Kingdom NG5 1PB. E-mail philip.bath@nottingham.ac.uk

Graeme J. Hankey MD, FRCP Section Editor

Key Words: colony-stimunlating factors • recovery • stem cells • stroke

An extract of the first 250 words of the full text is provided, because this article has no abstract.

	Introduction

 
Colony stimulating factors (CSFs), also called hematopoietic growth factors, regulate bone marrow production of circulating blood cells. They have been shown to be neuroprotective in experimental stroke. Some CSFs also mobilize the release of bone marrow stem cells into the circulation; these could help brain repair processes after stroke. We systematically assessed the effects of CSFs on functional outcome and hematology measures in patients with recent stroke.

	Search Strategy

 
We searched the Cochrane Stroke Group Trials Register, the Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, EMBASE and Science Citation Index. Principal investigators of trials were also contacted. Unconfounded randomized controlled trials recruiting patients with acute or subacute ischemic or hemorrhagic stroke were included. CSFs included stem cell factor, erythropoietin (EPO), granulocyte colony-stimulating factor (G-CSF), granulocyte-macrophage colony–stimulating factor (GM-CSF), macrophage colony–stimulating factor (M-CSF, CSF-1), and thrombopoietin, or analogues of these. The primary outcome was functional outcome (assessed as combined death or disability and dependency using scales such as the modified Rankin Scale or Barthel Index) at the end of the trial. Secondary outcomes included safety at the end of treatment (death, impairment, deterioration, extension or recurrence), death at the end of follow-up, and hematology measures. Data on measures by intention to treat were collected and analyzed using random-effects models.

	Main Results

 
No large trials were identified. EPO therapy was associated with a nonsignificant reduction in death or dependency in 1 small trial (n=40 participants, odds ratio 0.66; 95% CI, 0.19 to 2.31; Figure) but had no significant effect on hematological measures.¹ G-CSF was . . . [Full Text of this Article]