How I treat patients who mobilize hematopoietic stem cells poorly

To, L. Bik, Levesque, Jean-Pierre and Herbert, Kirsten E. (2011) How I treat patients who mobilize hematopoietic stem cells poorly. Blood, 118 17: 4530-4540. doi:10.1182/blood-2011-06-318220


Author To, L. Bik
Levesque, Jean-Pierre
Herbert, Kirsten E.
Title How I treat patients who mobilize hematopoietic stem cells poorly
Journal name Blood   Check publisher's open access policy
ISSN 0006-4971
1528-0020
Publication date 2011-10
Sub-type Article (original research)
DOI 10.1182/blood-2011-06-318220
Volume 118
Issue 17
Start page 4530
End page 4540
Total pages 11
Place of publication Washington, DC, United States
Publisher American Society of Hematology
Collection year 2012
Language eng
Formatted abstract
Transplantation with 2-5 x 10mobilized 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. 
Keyword Colony Stimulating Factor
Blood Progenitor Cells
Non-Hodgkins Lymphoma
Bone Marrow Transplantation
Q-Index Code C1
Q-Index Status Confirmed Code
Institutional Status UQ

Document type: Journal Article
Sub-type: Article (original research)
Collections: Official 2012 Collection
School of Medicine Publications
 
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