Diabetes Limits Stem Cell Mobilization Following G-CSF but Not Plerixafor

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Gian Paolo Fadini1, Mark Fiala2, Roberta Cappellari3

  • 1Division of Metabolic Diseases, Department of Medicine, University of Padova, Padova, Italy Laboratory of Experimental Diabetology, Venetian Institute of Molecular Medicine, Padova, Italy gianpaolo.fadini@unipd.it.

Diabetes
|March 26, 2015
PubMed

Insights

Diabetes impairs hematopoietic stem cell (HSC) mobilization with G-CSF. Plerixafor, however, effectively mobilizes HSCs in diabetic patients, offering a promising alternative for stem cell transplantation.

Area of Science:

  • Hematology
  • Endocrinology
  • Transplantation Medicine

Background:

  • Diabetes mellitus is known to negatively affect hematopoietic stem cell (HSC) function.
  • Previous research indicates impaired HSC mobilization in response to granulocyte colony-stimulating factor (G-CSF) in diabetic patients.

Purpose of the Study:

  • To investigate the efficacy of the CXCR4 antagonist plerixafor in mobilizing HSCs in patients with diabetes.
  • To compare plerixafor's mobilization capacity with G-CSF in diabetic versus non-diabetic individuals.

Main Methods:

  • Prospective study comparing plerixafor-induced CD34(+) HSC mobilization in 10 diabetic and 10 non-diabetic individuals.
  • Retrospective analysis of 706 patients undergoing autologous transplantation (G-CSF +/- chemotherapy vs. G-CSF + plerixafor).
  • Retrospective analysis of 335 patients undergoing allogeneic transplantation (G-CSF).

Main Results:

  • Plerixafor equally mobilized CD34(+) HSCs in diabetic and non-diabetic groups.
  • G-CSF showed reduced efficacy in diabetic patients in historical and retrospective data.
  • Diabetes was associated with poorer HSC mobilization with G-CSF (with/without chemotherapy), but not with G-CSF plus plerixafor.

Conclusions:

  • Diabetes negatively impacts HSC mobilization with G-CSF, but not with G-CSF combined with plerixafor.
  • Plerixafor represents a viable option for stem cell mobilization in diabetic patients undergoing transplantation.
  • Findings have significant implications for managing diabetic patients in stem cell transplantation and regenerative medicine.

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