1. ¹Department of Medicine, Washington University School of Medicine, St Louis, MO, USA
2. ²Department of Medicine, Case Western Reserve University School of Medicine, Cleveland, OH, USA
3. ³The Ohio State University School of Medicine and Public Health, Columbus, OH, USA

Correspondence: Dr SM Devine, The Ohio State University School of Medicine and Public Health, B316 Starling Loving Hall, 320 W 10th Avenue, Columbus, OH 43210, USA. E-mail: steven.devine@osumc.edu

Received 19 January 2007; Accepted 19 January 2007; Published online 19 March 2007.

Abstract

Currently, granulocyte colony stimulating factor (G-CSF) remains the standard mobilizing agent for peripheral blood stem cell (PBSC) donors, allowing the safe collection of adequate PBSCs from the vast majority of donors. However, G-CSF mobilization can be associated with some significant side effects and requires a multi-day dosing regimen. The other cytokine approved for stem cell mobilization, granulocyte-macrophage colony stimulating factor (GM-CSF), alters graft composition and may reduce the development of graft-versus-host disease, but a significant minority of donors fails to provide sufficient CD34+ cells with GM-CSF and some experience unacceptable toxicity. AMD3100 is a promising new mobilizing agent, which may have several advantages over G-CSF for donor mobilization. As it is a direct antagonist of the interaction between the chemokine stromal-derived factor-1 and its receptor CXCR4, AMD3100 mobilizes PBSCs within hours rather than days. It is also well tolerated, with no significant side effects reported in any of the clinical trials to date. Studies of autologous and allogeneic transplantation of AMD3100 mobilized grafts have demonstrated prompt and stable engraftment. Here, we review the current state of stem cell mobilization in normal donors and discuss novel strategies for donor stem cell mobilization.