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Structured Motor Rehabilitation After Selective Nerve Transfers
Published on: August 15, 2019
Can every patient be mobilized?
1Washington University School of Medicine, St Louis, Missouri 63110, United States. jdipers@dom.wustl.edu
There are several ways to mobilize hematopoietic stem cells for autologous and allogeneic hematopoietic stem cell transplant by manipulating the bone marrow microenvironment. Granulocyte colony-stimulating factor (G-CSF) and chemotherapy have been commonly used to mobilize stem cells, but several new agents, such as the CXCR4 inhibitor plerixafor, inhibit stromal-stem cell interactions to improve stem cell yield. The minimum threshold for engraftment is 2 × 10⁶ CD34+ cells/kg, but it has been shown that higher CD34+ stem cell dose, such as 5 × 10⁶ CD34+ cells/kg, is associated with improved survival. Efforts to increase stem cell yield remain important to improve outcomes.
There are several ways to mobilize hematopoietic stem cells for autologous and allogeneic hematopoietic stem cell transplant by manipulating the bone marrow microenvironment. Granulocyte colony-stimulating factor (G-CSF) and chemotherapy have been commonly used to mobilize stem cells, but several new agents, such as the CXCR4 inhibitor plerixafor, inhibit stromal-stem cell interactions to improve stem cell yield. The minimum threshold for engraftment is 2 × 10⁶ CD34+ cells/kg, but it has been shown that higher CD34+ stem cell dose, such as 5 × 10⁶ CD34+ cells/kg, is associated with improved survival. Efforts to increase stem cell yield remain important to improve outcomes.
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