Goker Hakan, Etgul Sezgin, Buyukasik Yahya
Hematology Department, Hacettepe University School of Medicine, Ankara, Turkey.
Hematology Department, Hacettepe University School of Medicine, Ankara, Turkey.
Transfus Apher Sci. 2015 Aug;53(1):23-9. doi: 10.1016/j.transci.2015.05.011. Epub 2015 Jun 9.
Peripheral blood stem cell collection is currently the most widely used source for hematopoietic autologous transplantation. Several factors such as advanced age, previous chemotherapy, disease and marrow infiltration at the time of mobilization influence the efficacy of CD34(+) progenitor cell mobilization. Despite the safety and efficiency of the standard mobilization protocols (G-CSF ± chemotherapy), there is still a significant amount of mobilization failure rate (10-40%), which necessitate novel agents for effective mobilization. Plerixafor, is a novel agent, has been recently approved for mobilization of hematopoietic stem cells (HSCs). The combination of Plerixafor with G-CSF provides the collection of large numbers of stem cells in fewer apheresis sessions and can salvage those who fail with standard mobilization regimens. The development and optimization of practical algorithms for the use Plerixafor is crucial to make hematopoietic stem cell mobilization more efficient in a cost-effective way. This review is aimed at summarizing how to identify poor mobilizers, and define rational use of Plerixafor for planning mobilization in hard-to-mobilize patients.
外周血干细胞采集是目前造血自体移植中应用最广泛的来源。动员时的高龄、既往化疗、疾病及骨髓浸润等多种因素会影响CD34(+)祖细胞动员的效果。尽管标准动员方案（粒细胞集落刺激因子±化疗）具有安全性和有效性，但仍有相当比例的动员失败率（10%-40%），这就需要新型药物来实现有效的动员。普乐沙福是一种新型药物，最近已被批准用于造血干细胞（HSCs）的动员。普乐沙福与粒细胞集落刺激因子联合使用，能在较少的单采次数中采集到大量干细胞，并能挽救那些标准动员方案失败的患者。开发和优化普乐沙福使用的实用算法，对于以具有成本效益的方式提高造血干细胞动员效率至关重要。本综述旨在总结如何识别动员不佳者，并确定合理使用普乐沙福以规划难治性患者的动员方案。
