造血干细胞动员:不同方案的优缺点及预测模型与技术提升  

Hematopoietic stem cell mobilization:advantages and disadvantages of different plans and improvements in predictive models and technologies

作　　者：韩孟君 许芳 Han Mengjun;Xu Fang(School of Medicine,University of Electronic Science and Technology of China,Chengdu 611731,Sichuan Province,China;Mianyang Central Hospital,Mianyang Hospital Affiliated to the School of Medicine of University of Electronic Science and Technology of China,Mianyang 621000,Sichuan Province,China)

机构地区：[1]电子科技大学医学院,四川省成都市611731 [2]电子科技大学医学院附属绵阳医院,绵阳市中心医院,四川省绵阳市621000

出　　处：《中国组织工程研究》2025年第36期7863-7871,共9页Chinese Journal of Tissue Engineering Research

基　　金：“四川省抗癌协会临床科研”重点课题(XH20235006),项目负责人:许芳;绵阳市中心医院院级课题(2023YJ004),项目负责人:许芳。

摘　　要：背景:造血干细胞移植是一种广泛应用于血液系统恶性和非恶性疾病的重要治疗手段,动员和收集足够的造血干细胞是保证患者移植后快速、持续造血功能重建的前提,但最常用的粒细胞集落刺激因子联合或不联合化疗的经典方案仍有10%-40%的动员失败率。目的:综述近年来造血干细胞动员现状,分析不同方案的优缺点,展望未来动员新方案。方法:以“造血干细胞,造血干细胞移植,造血干细胞动员,细胞因子,血小板生成素,CXCR4拮抗剂,整合素拮抗剂,化疗,动员效能”为中文关键词,以“hematopoietic stem cell,hematopoietic stem cell transplantation,hematopoietic stem cell mobilization,cytokines,thrombopoietin,CXCR4 antagonists,integrin antagonist,chemotherapy,mobilization efficiency”为英文关键词,在CNKI、PubMed、万方数据库进行检索,文献语种限制为中文、英文,检索年限为1990-2024年,共检索到300多篇文献,最终纳入68篇文献进行分析。结果与结论:越来越多的研究发现粒细胞集落刺激因子联合普乐沙福、白细胞介素、血小板生成素及整合素拮抗剂等能够更加有效地动员造血干细胞,联合使用可以减少粒细胞集落刺激因子的使用剂量,减少相关不良反应。一些新药如可溶性重组flt3-配体(简称CDX-301)、双重α9β1/α4β1整合素抑制剂BOP等可与粒细胞集落刺激因子联合,促进造血干细胞动员。此外还发现一些潜在的动员靶点如前列腺素E2受体及1-磷酸鞘氨醇等,尚在研究阶段。除固有的患者特征、治疗特征外,开发纳入生物标志物的预测模型,有助于有效预测造血干细胞动员失败,提升干细胞动员技术。BACKGROUND:Hematopoietic stem cell transplantation is a widely used treatment method to cure malignant and nonmalignant diseases originated from hematological cells.Mobilization and collection of sufficient hematopoietic stem cells are the preconditions to ensure rapid and sustained hematopoietic reconstitution after hematopoietic stem cell transplantation.However,the most commonly used granulocyte colony-stimulating factor with or without chemotherapy still has a mobilization failure rate of 10%to 40%.OBJECTIVE:To review the present status of hematopoietic stem cell mobilization in recent years,analyze the advantages and disadvantages of different mobilization plans,and be looking forward for new mobilization methods.METHODS:Using“hematopoietic stem cell,hematopoietic stem cell transplantation,hematopoietic stem cell mobilization,cytokines,thrombopoietin,CXCR4 antagonists,integrin antagonist,chemotherapy,mobilization efficiency”as Chinese and English keywords,articles published from 1990 to 2024 were searched on CNKI,PubMed,and WanFang databases.A total of more than 300 articles were retrieved,and 68 articles were finally included.RESULTS AND CONCLUSION:More and more studies have found that granulocyte colony-stimulating factor combined with other agents including plerixafor,interleukins,thrombopoietin,and integrin antagonist could improve hematopoietic stem cell mobilization.Combined use can reduce the dose of granulocyte colony-stimulating factor and related adverse reactions.Some new drugs,such as soluble recombinant FLT3-ligand(CDX-301)and dualα9β1/α4β1 integrin inhibitor BOP,can be combined with granulocyte colony-stimulating factor to promote hematopoietic stem cell mobilization.In addition,some potential mobilization targets,such as prostaglandin E2 receptor and sphingosine 1-phosphate,are still in the research stage.In addition to inherent patient characteristics and treatment options,incorporating biomarkers into the factors affecting mobilization and developing new predictive models will help t

关 键 词：造血干细胞 造血干细胞移植 造血干细胞动员 细胞因子 血小板生成素 CXCR4拮抗剂 整合素拮抗剂 化疗 动员效能 

分 类 号：R459.9[医药卫生—治疗学] R318[医药卫生—临床医学] R551