Diabetes mellitus as a poor mobilizer condition

Area of Science:

• Hematology
• Stem Cell Biology
• Endocrinology

Background:

• Hematopoietic stem cell (HSC) transplantation is a curative therapy for hematological malignancies.
• Mobilization of HSCs from bone marrow (BM) to peripheral blood (PB) is crucial for transplantation.
• A significant percentage of patients fail to mobilize adequate HSC numbers with standard G-CSF treatment.

Purpose of the Study:

• To review evidence linking diabetes mellitus to impaired HSC mobilization.
• To elucidate the mechanisms behind "diabetic stem cell mobilopathy".

Main Methods:

• Review of experimental studies on the effects of diabetes on the HSC niche.
• Analysis of clinical data on HSC mobilization in diabetic patients.
• Examination of the role of hyperglycemia and CXCL12 regulation.

Main Results:

• Diabetes mellitus significantly remodels the bone marrow niche, impairing HSC release.
• Hyperglycemia disrupts CXCL12 regulation, a key factor in HSC homing.
• Diabetic patients show reduced HSC mobilization in response to G-CSF, but less so to plerixafor.

Conclusions:

• Diabetes mellitus is a risk factor for poor HSC mobilization, impacting transplantation success.
• Understanding the biochemical changes in the diabetic bone marrow is essential.
• Future therapies may aim to reverse the impaired HSC mobilization seen in diabetes.