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Hematopoiesis01:21

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The process of blood cell formation is called hematopoiesis. Hematopoiesis starts early during development, on the seventh day of embryogenesis. This phase of hematopoiesis is called the primitive wave, wherein the extraembryonic yolk sac allows the production of erythroid cells and endothelial cells from a common precursor called hemangioblast. The erythroid cells provide oxygen to support the growth of the rapidly dividing embryo. Hemangioblasts later develop into hematopoietic stem cells or...
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The hematopoietic stem cells or HSCs are multipotent, meaning they can differentiate and give rise to all blood and immune cells. HSCs are maintained in the quiescent stage until an external stimulus initiates their differentiation. The multipotent HSCs exist as two heterogeneous populations, long-term repopulating cells (LTRC) and short-term repopulating cells (STRC). The two HSC populations have different surface markers or receptors and are classified based on quiescence and long-term...
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The current status in hematopoietic stem cell mobilization.

Sinem Civriz Bozdag1, Emre Tekgunduz2, Fevzi Altuntas2

  • 1Hematology Department, Ankara University School of Medicine, Ankara, Turkey.

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|March 20, 2015
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Summary

Hematopoietic stem cell mobilization using cytokines is standard, but failure occurs in one-third of patients. Plerixafor combined with G-CSF offers a new, effective salvage strategy for poor mobilizers.

Keywords:
stem cell mobilization

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Area of Science:

  • Hematology
  • Stem Cell Transplantation
  • Pharmacology

Background:

  • Cytokine therapy is the standard initial approach for hematopoietic stem cell mobilization.
  • Chemotherapy-based mobilization is an option for high-risk patients or remobilization.
  • Mobilization failure affects approximately one-third of patients, necessitating salvage strategies.

Purpose of the Study:

  • To evaluate the efficacy of salvage strategies for hematopoietic stem cell mobilization failure.
  • To highlight the role of plerixafor, a CXCR4 inhibitor, in improving mobilization outcomes.
  • To explore novel agents for addressing mobilization failure.

Main Methods:

  • Review of studies investigating salvage mobilization strategies.
  • Analysis of the synergistic effect of plerixafor with G-CSF (granulocyte-colony stimulating factor).
  • Examination of preemptive, immediate salvage, and remobilization approaches using plerixafor.

Main Results:

  • Plerixafor in combination with G-CSF has shown convincing results in various studies for poor mobilizers.
  • Preemptive, immediate salvage, and remobilization strategies with plerixafor have demonstrated efficacy.
  • Alternative agents including other CXCR4 inhibitors, VLA4 inhibitors, bortezomib, and parathormone are emerging.

Conclusions:

  • Plerixafor represents a significant advancement in managing hematopoietic stem cell mobilization failure.
  • Salvage strategies, particularly those involving plerixafor, offer renewed hope for patients with mobilization challenges.
  • Ongoing research into novel agents promises further improvements in stem cell mobilization techniques.