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多发性骨髓瘤中的干细胞动员:挑战、策略和最新进展。

Stem cell mobilization in multiple myeloma: challenges, strategies, and current developments.

机构信息

Department of Hematology, Nanfang Hospital, Southern Medical University, No. 1838 Guangzhou Avenue North, Guangzhou, 510515, China.

出版信息

Ann Hematol. 2023 May;102(5):995-1009. doi: 10.1007/s00277-023-05170-0. Epub 2023 Mar 22.

Abstract

Among hematological malignancies, multiple myeloma (MM) represents the leading indication of autologous hematopoietic stem cell transplantation (auto-HCT). Auto-HCT is predominantly performed with peripheral blood stem cells (PBSCs), and the mobilization and collection of PBSCs are essential steps for auto-HCT. Despite the improved success of conventional methods with the incorporation of novel agents for PBSC mobilization in MM, mobilization failure is still a concern. The current review comprehensively summarizes various mobilization strategies for mobilizing PBSCs in MM patients and the evolution of these strategies over time. Moreover, existing evidence substantiates that the mobilization regimen used may be an important determinant of graft content. However, limited data are available on the effects of graft characteristics in patient outcomes other than hematopoietic engraftment. In this review, we discussed the effect of graft characteristics on clinical outcomes, mobilization failure, factors predictive of poor mobilization, and potential mobilization regimens for such patients.

摘要

在血液系统恶性肿瘤中,多发性骨髓瘤(MM)是自体造血干细胞移植(auto-HCT)的主要适应证。auto-HCT 主要采用外周血干细胞(PBSC)进行,而 PBSC 的动员和采集是 auto-HCT 的关键步骤。尽管在 MM 患者中采用新型 PBSC 动员药物的常规方法的成功率有所提高,但动员失败仍然是一个令人关注的问题。本综述全面总结了 MM 患者中动员 PBSC 的各种动员策略以及这些策略随时间的演变。此外,现有证据证实,所使用的动员方案可能是移植物含量的重要决定因素。然而,关于移植物特征对造血植入以外的患者结局的影响,数据有限。在这篇综述中,我们讨论了移植物特征对临床结局、动员失败、预测动员不佳的因素以及此类患者的潜在动员方案的影响。

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An approach to autologous stem cell mobilization: trying to define good mobilizers.一种自体干细胞动员的方法:尝试定义有效的动员剂。
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