Peter MacCallum Cancer Centre, Department of Hematology and Medical Oncology, Victoria, Australia.
Expert Opin Biol Ther. 2010 Jan;10(1):113-25. doi: 10.1517/14712590903473123.
The mobilization and collection of hematopoietic stem and progenitor cells (HSPC) is central to many potentially curative treatments for cancer and some non-malignant conditions. Recombinant human cytokines have been the mainstay of therapeutic HSPC mobilization, particularly G-CSF. Even with currently used mobilization regimens using G-CSF with or without chemotherapy, up to 60% of patients can fail to mobilize enough HSPC for a transplant procedure. Recombinant human stem cell factor (ancestim, rhSCF, Stemgen) is another such cytokine, which has shown promising synergy when used in combination with G-CSF for HSPC mobilization. It provides a useful second-line option for prior failed-mobilizer patients and those who are anticipated to mobilize poorly due to recognised risk factors. It may also have utility in promoting bone marrow recovery in cases of refractory bone marrow failure such as aplastic anaemia and prolonged non-engraftment after allogeneic HSPC transplantation. We review the literature supporting the use of rhSCF in the context of HSPC mobilization and bone marrow failure. The emergence of other novel agents for HSPC mobilization such as plerixafor (AMD3100, Mozobil) will further demarcate the role of Ancestim as a second- or third-line mobilization agent for the mobilization-refractory patient.
造血干细胞和祖细胞（HSPC）的动员和采集是许多潜在治愈癌症和某些非恶性疾病治疗方法的核心。重组人细胞因子一直是治疗性 HSPC 动员的主要手段，尤其是 G-CSF。即使使用目前使用 G-CSF 联合或不联合化疗的动员方案，仍有多达 60%的患者无法动员足够的 HSPC 进行移植手术。重组人干细胞因子（ancestim、rhSCF、Stemgen）是另一种这样的细胞因子，当与 G-CSF 联合用于 HSPC 动员时，显示出有希望的协同作用。它为先前动员失败的患者和因已知危险因素预计动员不佳的患者提供了有用的二线选择。它还可能在促进骨髓衰竭（如再生障碍性贫血）和异基因 HSPC 移植后骨髓非植入的情况下促进骨髓恢复方面具有实用性。我们回顾了支持 rhSCF 在 HSPC 动员和骨髓衰竭背景下使用的文献。其他新型 HSPC 动员药物（如plerixafor（AMD3100、Mozobil）的出现将进一步确定 Ancestim 作为动员抵抗患者的二线或三线动员药物的作用。
