Can every patient be mobilized?
There are several ways to mobilize hematopoietic stem cells for autologous and allogeneic hematopoietic stem cell transplant by manipulating the bone marrow microenvironment. Granulocyte colony-stimulating factor (G-CSF) and chemotherapy have been commonly used to mobilize stem cells, but several new agents, such as the CXCR4 inhibitor plerixafor, inhibit stromal-stem cell interactions to improve stem cell yield. The minimum threshold for engraftment is 2 × 10⁶ CD34+ cells/kg, but it has been shown that higher CD34+ stem cell dose, such as 5 × 10⁶ CD34+ cells/kg, is associated with improved survival. Efforts to increase stem cell yield remain important to improve outcomes.
Washington University School of Medicine, St Louis, Missouri 63110, United States. jdipers@dom.wustl.edu
John F
JF
DiPersio
D019380:Anti-HIV Agents / Q000627:therapeutic use*; D018952:Antigens, CD34; D001596:Benzylamines; D002450:Cell Communication / Q000187:drug effects; D000080027:Cyclams; D016179:Granulocyte Colony-Stimulating Factor / Q000627:therapeutic use*; D019650:Hematopoietic Stem Cell Mobilization / Q000379:methods*; D018380:Hematopoietic Stem Cell Transplantation; D006412:Hematopoietic Stem Cells / Q000378:metabolism*; D006571:Heterocyclic Compounds / Q000627:therapeutic use*; D006801:Humans; D019718:Receptors, CXCR4 / Q000037:antagonists & inhibitors / Q000235:genetics; D017154:Stromal Cells / Q000378:metabolism; D014184:Transplantation, Homologous
D019380:Anti-HIV Agents; D018952:Antigens, CD34; D001596:Benzylamines; C527276:CXCR4 protein, human; D000080027:Cyclams; D006571:Heterocyclic Compounds; D019718:Receptors, CXCR4; D016179:Granulocyte Colony-Stimulating Factor; C088327:plerixafor