Mobilization of peripheral blood stem cells

Area of Science:

• Hematology
• Transplantation Medicine
• Cellular Therapy

Background:

• Peripheral blood stem cells (PBSC) are increasingly used for hematopoietic stem cell transplantation, largely replacing traditional bone marrow transplantation.
• Mobilization of PBSC significantly increases the number of circulating CD34+ cells, crucial for successful engraftment.

Purpose of the Study:

• To review the methods for mobilizing PBSC for transplantation.
• To discuss the adverse events associated with PBSC mobilization.
• To explore strategies for optimizing CD34+ cell yield.

Main Methods:

• Review of current literature on PBSC mobilization strategies.
• Analysis of factors influencing CD34+ cell mobilization, including chemotherapy, growth factors, and patient-specific variables.
• Evaluation of large volume leukapheresis (LVL) for enhancing CD34+ cell collection.

Main Results:

• Chemotherapy and growth factors can increase CD34+ cells up to 6% of white blood cells (WBC).
• Granulocyte-colony stimulating factor (G-CSF) is standard for allogeneic PBSC mobilization.
• Common side effects include pain; serious complications like spleen rupture can occur.
• Large volume apheresis (LVL) can improve CD34+ yield in patients with low pre-collection counts.

Conclusions:

• PBSC mobilization is effective but associated with potential adverse events requiring careful management.
• Optimizing mobilization and collection strategies, such as LVL, is essential for maximizing CD34+ cell yield.
• Understanding factors influencing mobilization is key for successful stem cell transplantation.