Takeyama Kunihiko, Ohto Hitoshi
Division of Blood Transfusion and Transplantation Immunology, 1 Hikarigaoka, Fukushima Medical University, Fukushima 960-1295, Japan.
Transfus Apher Sci. 2004 Dec;31(3):233-43. doi: 10.1016/j.transci.2004.09.007.
Intentional recruitment of hematopoietic stem cells from bone marrow to peripheral blood is a clinical process termed peripheral blood stem cell (PSBC) mobilization. Mobilized PSBC has replaced bone marrow as the preferred source of stem cells for patients undergoing high-dose chemotherapy because of rapid and durable engraftment and reconstitution of functional bone marrow. Although the mechanism involved in the process of PBSC mobilization by cytokines is largely unknown, granulocyte colony-stimulating factor (G-CSF) alone or chemotherapy combined with GCSF is used as a mobilizing agent in current clinical practice. To date, G-CSF is the best cytokine for PBSC mobilization. However, there are some controversies in its efficacy (poor mobilizer) and safety (in allogeneic donors). Recent research progress has revealed some part of the mechanistic scenarios of PBSC mobilization and found promising candidates for the agents for PBSC mobilization. Until the research at molecular and cellular levels elucidates the precise mechanisms, collecting and comparing clinical observations is the best way to find more optimal condition for PBSC mobilization.
将造血干细胞从骨髓有意募集至外周血是一个临床过程,称为外周血干细胞(PSBC)动员。由于其能快速且持久地植入并重建功能性骨髓,动员后的外周血干细胞已取代骨髓,成为接受大剂量化疗患者的首选干细胞来源。尽管细胞因子介导外周血干细胞动员过程的机制尚不清楚,但在当前临床实践中,单独使用粒细胞集落刺激因子(G-CSF)或化疗联合G-CSF作为动员剂。迄今为止,G-CSF是外周血干细胞动员的最佳细胞因子。然而,其疗效(动员效果不佳)和安全性(在异基因供体中)存在一些争议。最近的研究进展揭示了外周血干细胞动员机制的部分情况,并发现了有前景的外周血干细胞动员剂候选物。在分子和细胞水平的研究阐明确切机制之前,收集和比较临床观察结果是找到外周血干细胞动员更优化条件的最佳方法。