How I treat patients who mobilize hematopoietic stem cells poorly
Top Cited Papers
- 27 October 2011
- journal article
- review article
- Published by American Society of Hematology in Blood
- Vol. 118 (17), 4530-4540
- https://doi.org/10.1182/blood-2011-06-318220
Abstract
Transplantation with 2-5 × 106 mobilized CD34+cells/kg body weight lowers transplantation costs and mortality. Mobilization is most commonly performed with recombinant human G-CSF with or without chemotherapy, but a proportion of patients/donors fail to mobilize sufficient cells. BM disease, prior treatment, and age are factors influencing mobilization, but genetics also contributes. Mobilization may fail because of the changes affecting the HSC/progenitor cell/BM niche integrity and chemotaxis. Poor mobilization affects patient outcome and increases resource use. Until recently increasing G-CSF dose and adding SCF have been used in poor mobilizers with limited success. However, plerixafor through its rapid direct blockage of the CXCR4/CXCL12 chemotaxis pathway and synergy with G-CSF and chemotherapy has become a new and important agent for mobilization. Its efficacy in upfront and failed mobilizers is well established. To maximize HSC harvest in poor mobilizers the clinician needs to optimize current mobilization protocols and to integrate novel agents such as plerixafor. These include when to mobilize in relation to chemotherapy, how to schedule and perform apheresis, how to identify poor mobilizers, and what are the criteria for preemptive and immediate salvage use of plerixafor.This publication has 111 references indexed in Scilit:
- Human prostate cancer metastases target the hematopoietic stem cell niche to establish footholds in mouse bone marrowJCI Insight, 2011
- Expression of the G-CSF receptor in monocytic cells is sufficient to mediate hematopoietic progenitor mobilization by G-CSF in miceThe Journal of Experimental Medicine, 2011
- Bone marrow CD169+ macrophages promote the retention of hematopoietic stem and progenitor cells in the mesenchymal stem cell nicheThe Journal of Experimental Medicine, 2011
- Predicting PBSC harvest failure using circulating CD34 levels: developing target-based cutoff points for early interventionBone Marrow Transplantation, 2010
- Novel insight into stem cell mobilization-Plasma sphingosine-1-phosphate is a major chemoattractant that directs the egress of hematopoietic stem progenitor cells from the bone marrow and its level in peripheral blood increases during mobilization due to activation of complement cascade/membrane attack complexLeukemia, 2010
- Impaired mobilization of hematopoietic stem/progenitor cells in C5-deficient mice supports the pivotal involvement of innate immunity in this process and reveals novel promobilization effects of granulocytesLeukemia, 2009
- Live-animal tracking of individual haematopoietic stem/progenitor cells in their nicheNature, 2008
- Plasmin therapy enhances mobilization of HPCs after G-CSFBlood, 2008
- Comparison of Lenograstim vs Filgrastim Administration following Chemotherapy for Peripheral Blood Stem Cell (PBSC) Collection: A Retrospective Study of 126 PatientsLeukemia & Lymphoma, 1999
- Autologous Bone Marrow Transplantation as Compared with Salvage Chemotherapy in Relapses of Chemotherapy-Sensitive Non-Hodgkin's LymphomaThe New England Journal of Medicine, 1995