Hematopoietic stem cell mobilization strategies to support high-dose chemotherapy: A focus on relapsed/refractory germ cell tumors

doi:10.5306/wjco.v12.i9.746

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World Journal of Clinical Oncology

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2218-4333

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Clin Oncol. Sep 24, 2021; 12(9): 746-766
Published online Sep 24, 2021. doi: 10.5306/wjco.v12.i9.746

Hematopoietic stem cell mobilization strategies to support high-dose chemotherapy: A focus on relapsed/refractory germ cell tumors

Eleni Porfyriou, Sylvia Letsa, Christos Kosmas

Eleni Porfyriou, Sylvia Letsa, Christos Kosmas, Department of Medical Oncology and Hematopoietic Cell Transplant Unit, “Metaxa” Cancer Hospital, Piraeus 18537, Greece

Author contributions: Porfyriou E and Letsa S collected and analyzed data, wrote, and approved the article; Kosmas C wrote parts of the original and made additions in the revised article, critically evaluated collected data, supervised the study, and corrected and approved the article; All authors read, approved, and agreed on submission of the final version of the article.

Conflict-of-interest statement: The authors declare that they have no conflicting interests.

Corresponding author: Eleni Porfyriou, MD, Doctor, Department of Medical Oncology and Hematopoietic Cell Transplant Unit, “Metaxa” Cancer Hospital, 51 Botassi Street, Piraeus 18537, Greece. porfyriou7@gmail.com

Received: May 3, 2021
Peer-review started: May 3, 2021
First decision: June 16, 2021
Revised: June 19, 2021
Accepted: July 30, 2021
Article in press: July 30, 2021
Published online: September 24, 2021
Processing time: 136 Days and 19 Hours

Core Tip

Core tip: High-dose chemotherapy (HDCT) followed by autologous stem cell transplantation (ASCT) is a curative treatment option for patients with relapsed/refractory germ cell tumors (GCTs). Mobilization of adequate numbers of hematopoietic stem cells (HSCs) is a prerequisite for successful ASCT. As the benefit of HDCT+ASCT is largely evident with > one HDCT cycle, it is anticipated that an appreciable percentage of patients will not mobilize adequate HSCs and require salvage strategies. Herein, we review the history of HSC transplantation, with emphasis in GCTs, pathophysiological mechanisms of HSC mobilization, initial and salvage mobilization strategies, and finally discuss novel mobilizing agents and approaches to overcome failures.