Hematopoietic Stem Cell Mobilization: A Clinical Protocol

Autologous hematopoietic stem cell transplantation is the standard treatment for a wide variety of malignancies. At present, most hematopoietic progenitor/stem cell (HPC) collections are collected from the peripheral blood via leukapheresis following chemotherapy and/or growth factor-mediated mobilization. Most mobilization regimens consist of chemotherapy followed by one or more growth factors such as G-CSF, GM-CSF, or plerixafor. Occasionally a subset of patients will prove unable to mobilize effectively and will not collect at least 2.0 � 3106 CD34+ cells/kg, the number of HPC currently considered to be appropriate for transplant in order to achieve timely engraftment and recovery of hematopoiesis. When this occurs it may be necessary to either remobilize, possibly with a different method, or to do a marrow harvest. Recent research has explored the benefits of using HPC outside of the oncology arena, notably in the area of cardiac regeneration following infarction, making the subject of mobilization potentially important to many areas of medicine.