***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Objectives Neutrophil function is defective in acute liver failure ( ALF ) and the in vitro ability of granulocyte colonystimulating factor ( G‐CSF ) to reverse these defects has been reported . The effects of administering G‐CSF to ALF patients are presented in this study . Design This was a prospect i ve , phase I/II , open label , study . Setting The liver intensive therapy unit at King 's College Hospital , London . Participants Sequential patients admitted with acute liver failure due to acetaminophen overdose . Interventions G‐CSF was given to four groups ( each n = 6 ) of ALF patients as a daily infusion at 25 , 50 , 100 or 150 μg/m2 . A  control group of eight patients did not receive G‐CSF . Main outcome measures Neutrophil phagocytosis and killing of Staphylococcus aureus and superoxide release before G‐CSF administration and at 24 and 96 h thereafter . Results Neutrophils from patients receiving 50 , 100 or 150 μg/m2 G‐CSF , but not from control patients or those receiving 25 μg/m2 , showed significantly increased phagocytosis and killing at 96 h. Doses of 50 or 150 μg/m2 G‐CSF result ed in increased superoxide production at 96 h. No patients discontinued treatment as a consequence of side effects related to G‐CSF administration . Conclusions G‐CSF administration is a safe and effective means of reversing the neutrophil defects of ALF , and may have a role in the prevention and treatment of infection in these patients . A dose of 50 μg/m2/day is as effective as higher doses and was associated with fewer side effects Background ‘ Acute-on-chronic liver failure ’ ( ACLF ) is characterised in a more advanced stage by liver failure associated with multiple other end-organ failure . The global clinical characteristics of this entity remain , however , ill-defined . Objective To characterise and evaluate the clinicopathological features of patients with ACLF compared with patients with chronic decompensated cirrhosis ( CHD ) in a prospect i ve , homogeneous cohort of patients with histologically proven alcoholic cirrhosis from 2002 to 2007 . Results In total 250 patients were screened (  ACLF ( n=70 , 28 % ) and CHD ( n=180 , 72 % ) ) . Alcoholic liver disease was observed in respectively 61/70 ( 87 % ) of patients with ACLF and 72/180 ( 40 % ) of patients with CHD . After exclusion of 31 patients , 102 patients were studied : 54 with ACLF ( median age 51 years ; Child – Pugh 12±2 ; in-hospital mortality 46 % ( 25/54 ) ) and 48 patients with CHD ( median age 53 years ; Child – Pugh 10±2 ; in-hospital mortality 10 % ( 5/48 ) ) . In the patients with ACLF who survived the hospital stay , the difference in transplant-free survival compared with patients with CHD tended to attenuate with time . At admission the apparent infection of patient groups was comparable but during hospitalisation infection occurred more frequently in patients with ACLF ( 31/53 ( 58 % ) ) than in those with CHD ( 12/47=26 % ) ( p=0.007 ) . Early signs of infection , positive systemic inflammatory response syndrome ( SIRS ) criteria at admission and ductular bilirubinostasis ( p=0.04 ) , were early features that predicted outcome in ACLF . Conclusion Patients with ACLF have a high short-term mortality but those who survived the acute exacerbation show a long-term outcome comparable to that of patients with CHD . Infection is the most common cause of mortality in these patients . Positive SIRS criteria and ductular bilirubinostasis are early markers of ACLF and might allow more rapid identification of high-risk patients AIM To evaluate the safety and efficacy of granulocyte-colony stimulating factor ( G-CSF ) therapy in patients with hepatitis B virus (HBV)-associated acute-on-chronic liver failure ( ACLF ) . METHODS Fifty-five patients with HBV-associated ACLF were r and omized into two groups : the treatment group and the control group . Twenty-seven patients in the treatment group received G-CSF ( 5 μg/kg per day , six doses ) treatment plus st and ard therapy , and 28 patients in the control group received st and ard therapy only .  The peripheral CD34(+ ) cell count was measured consecutively by flow cytometry . Circulating white blood cell count , biochemical parameters , and other clinical data of these patients were recorded and analyzed . All patients were followed up for a period of 3 mo to evaluate the changes in liver function and survival rate . RESULTS The peripheral neutrophil and CD34(+ ) cell counts in the G-CSF group increased on day 3 from the onset of therapy , continued to rise on day 7 , and remained elevated on day 15 compared to those of the control group . Child-Turcotte-Pugh score of patients in the treatment group was improved on day 30 from the onset of G-CSF therapy , compared to that in the controls ( P = 0.041 ) . Model for End-Stage of Liver Disease score of patients in the treatment group was improved on day 7 ( P = 0.004 ) and remained high on day 30 from the onset of G-CSF therapy ( P < 0.001 ) compared to that in controls . After 3 mo of follow-up observation , the survival rate in the treatment group ( 48.1 % ) was significantly higher than that in the control group ( 21.4 % ) ( P = 0.0181 ) . CONCLUSION G-CSF therapy promoted CD34(+ ) cell mobilization in patients with HBV-associated ACLF , and improved the liver function and the survival rate of these patients AIMS The aim of this open , r and omised , crossover , parallel-group study was to compare the pharmacokinetics and neutrophil responses of lenograstim when administered subcutaneously ( s.c . ) and intravenously ( i.v . ) . METHODS A total of 27 healthy male volunteers was recruited .  Lenograstim doses ( 0.5 , 2 , 5 , or 10 microg kg(-1 ) ) were administered s.c . or i.v . once-daily for 5 days , and then , after a 10-day washout period , vice versa for a further 5 days .  Lenograstim concentrations and absolute neutrophil counts ( ANCs ) were measured predosing and postdosing on days 1 and 5 . RESULTS Maximum serum concentrations of lenograstim  were higher following i.v . dosing ( mean 5.2 - 185.5 vs 0.7 - 30.0 ng ml(-1 ) after s.c . dosing on day 1 ) and attained sooner ( median 0.5 - 0.8 vs 4.7 - 8.7 h on day 1 ) . However , apparent elimination half-lives of lenograstim were longer following s.c . dosing ( mean 2.3 - 3.3 vs 0.8 - 1.2 h after i.v . dosing on days 1 and 5 ) . ANCs increased in a dose-dependent manner with both routes of lenograstim , but more prolonged rises and higher ANC peaks were attained following s.c . doses . ANCs peaked on day 6 following 5 microg kg(-1 ) s.c . doses ( mean peak=26.3x10(9 ) cells l(-1 ) ) , but on day 2 after 5 microg kg(-1 ) i.v . doses ( mean peak = 12.4 x 10(9 ) cells l(-1 ) ) . Irrespective of route , the most common adverse events were headaches and back/spine pain ; at doses of up to 5 microg kg(-1 ) these were mild and generally well tolerated . CONCLUSIONS While supporting the use of both s.c . and i.v . administered lenograstim to treat neutropenia , these results demonstrate that neutrophil responses are more sustained and prolonged with the s.c . route BACKGROUND / AIM We aim ed to evaluate safety and efficacy of granulocyte-colony stimulating factor treatment in patients with acute on chronic liver failure and the effect of granulocyte-colony stimulating factor on the expression level of CXCR4 , vascular endothelial growth factor receptor and very late activation antigen 4 . METHODS Twenty-four patients with acute on chronic liver failure were r and omised to receive st and ard therapy , st and ard therapy+granulocyte-colony stimulating factor ( 5 microg/kg/day for 6 days ) and st and ard therapy+granulocyte-colony stimulating factor ( 15 microg/kg/day s.c . for 6 days ) . Data on CD34+cell mobilisation were compared to age-matched peripheral blood haematopoietic stem cell donors treated with granulocyte-colony stimulating factor . On day third of treatment , the expression level of CXCR4 , vascular endothelial growth factor receptor and very late activation antigen 4 was analysed in mobilised CD34 + cells . RESULTS CD34 cell count increased after the second day of granulocyte-colony stimulating factor injection in both treatment groups compared to the linear increase observed in control . After the fifth day the increase was significantly higher in healthy donors versus patients with acute on chronic liver failure . A decrease in the expression of CXCR4 , very late activation antigen 4 and vascular endothelial growth factor receptor compared to premobilisation values was observed . No major side effects were observed . CONCLUSIONS Granulocyte-colony stimulating factor treatment is able to induce CD34 mobilisation in patients with acute on chronic liver failure . The expression pattern of CXCR4 , very late activation antigen 4 and vascular endothelial growth factor receptor suggests that these molecules are involved in the granulocyte-colony stimulating factor-induced stem cell mobilisation BACKGROUND & AIMS Acute-on-chronic liver failure ( ACLF ) develops in patients with chronic liver disease and has high mortality . Mobilization of bone marrow-derived stem cells with granulocyte colony-stimulating factor ( G-CSF ) could promote hepatic regeneration . METHODS Consecutive patients with ACLF were r and omly assigned to groups given 5 μg/kg G-CSF subcutaneously ( 12 doses ; group A , n = 23 ) or placebo ( group B , n = 24 ) plus st and ard medical therapy . We assessed survival until day 60 ; Child-Turcotte-Pugh ( CTP ) , Model for End-Stage Liver Disease ( MELD ) , and Sequential Organ Failure Assessment ( SOFA ) scores ; and the development of other related complications . RESULTS After 1 week of treatment , group A had higher median leukocyte and neutrophil counts than group B ( P < .001 ) . Sixteen patients in group A ( 69.6 % ) and 7 in group B ( 29 % ) survived ; the actuarial probability of survival at day 60 was 66 % versus 26 % , respectively ( P = .001 ) . Treatment with G-CSF also reduced CTP scores in group A by a median of 33.3 % compared with an increase of 7.1 % in group B ( P = .001 ) , along with MELD ( median reduction of 15.3 % compared with an increase of 11.7 % in group B ; P = .008 ) and SOFA scores ( median reduction of 50 % compared with an increase of 50 % in group B ; P = .001 ) . The percentages of patients who developed hepatorenal syndrome , hepatic encephalopathy , or sepsis were lower in group A than in group B ( 19 % vs 71 % [ P = .0002 ] , 19 % vs 66 % [ P = .001 ] , and 14 % vs 41 % [ P = .04 ] , respectively ) . After 1 month of treatment , G-CSF  increased the number of CD34(+ ) cells in the liver ( by 45 % compared with 27.5 % in group B ; P = .01 ) . CONCLUSIONS G-CSF therapy more than doubles the percentage of patients with ACLF who survive for 2 months ; it also significantly reduces CTP , MELD , and SOFA scores and prevents the development of sepsis , hepatorenal syndrome , and hepatic encephalopathy BACKGROUND / AIMS To evaluate feasibility , safety and pattern of bone marrow-derived cells ( BMC ) mobilization in patients with end stage liver cirrhosis following granulocyte-colony stimulating factor ( G-CSF ) administration . METHODS Eight patients with severe liver cirrhosis ( Child-Pugh score B-C , spleen diameter less than 170 mm ) were included . They were treated with G-CSF ( 5 microg/kg b.i.d for three consecutive days ) to mobilize BMC , evaluated as circulating CD34+ve cells ( flow cytometry ) and myeloid CFU-GM progenitors ( in vitro colony growth assay ) . Co-expression in CD34+ve cells markers of differentiation ( Thy1 , CD133 , CXCR4 , c1qRp ) were investigated on CD34+ve cells by double direct immunofluorescence 
    Output:
    
In conclusion , the use of G-CSF for the treatment of patients with ACLF significantly reduced short-term mortality .