How we mobilize haemopoietic stem cells

Abstract

Mobilization and collection of haemopoietic stem and progenitor cells (HSPC) is the cornerstone of autologous and allogeneic stem cell transplantation for a wide variety of haematological and some non-haematological malignancies. Centres providing this service face the challenge of optimizing the likelihood of successful collection of transplantable doses of cells, while maximizing the efficiency of the apheresis unit and minimizing the risk of toxicity as well as mobilization failure. Recent developments in the understanding of the molecular mechanisms of mobilization have led to the emergence of novel strategies for HSPC mobilization, which may assist in meeting these imperatives. The task for clinicians is how to incorporate the use of these strategies into practice, in the light of emerging evidence for efficacy and safety of these agents. Herein, the literature is reviewed, and a proposed algorithm for HSPC mobilization is presented.

Hematopoietic stem cells: An overview

“…The interaction between CXCR4 and CXCL12 (SDF-1) is responsible for HSC homing and retention in the niche. Disruption of the CXCR4/CXCL12 (SDF-1) interaction in HSC niche in addition to downregulation of CXCL12 (SDF-1) expression in stromal cells by G-CSF and other mobilizing cytokines are thought to be the mechanisms for HSC mobilization [50,51]. Currently, recombinant human G-CSF produced in Escherichia coli is the agent most commonly used to elicit HSC mobilization in the clinic.…”

Mobilization of hematopoietic progenitor cells for autologous transportation: consensus recommendations

“…Finally, isolated reports seem to indicate that the addition of bone marrow cells to peripheral blood progenitor cells may benefit patients with poor mobilization. 10,42,59 Recommendation: in cases of mobilization failure, it is recommended to allow at least 3 …”

“…Options for remobilization include dividing the G-CSF dose, remobilization with chemotherapy and G-CSF, remobilization with the same previous regimen, the combination of plerixafor and G-CSF and bone marrow collection. 10,42,59 Mobilization failures are generally defined as <2*106 CD34+ cells collected per kg in a single mobilization or more than 4 sessions of apheresis to collect this minimum number of cells. 10 The division of the G-CSF dose seems to be effective in approximately 1/3 of the patients; however, confirmatory data regarding the effectiveness of this strategy are scarce.…”

Personalized Medicine: State-of-the-Art and Prospects

“…Однако, как было показано в последние годы, эти клетки активно участвуют и в регенерации других тканей. Стволовые клетки кост-ного мозга могут дифференцироваться в кардиомио-циты, гладкомышечные и скелетные миобласты, эндоте-лиоциты, остеобласты, гепатоциты и даже, при наличии соответствующих дифференцировочных сигналов, в глиальные клетки и нейроны [80,81]. Аналогичные результаты были получены при исследовании возмож-ностей дифференцировки мезенхимальных стволовых клеток, полученных из костного мозга и жировой ткани.…”