A critical component of both autologous and allogeneic hematopoietic stem cell transplantation is the infusion of sufficient numbers of hematopoietic stem cells. The hematopoietic stem cells reside primarily in the red bone marrow, which, like seeds, can take root, replicate themselves, and differentiate into a variety of blood cells, although they are present in only about 1% of the bone marrow.
In order to obtain enough stem cells, early transplants required hemi-anesthesia of the donor and about 1000 mL of bone marrow blood from the iliac bone to be collected for the transplant to proceed properly.
By the 1990s, it was discovered that the application of cell mobilizers could mobilize hematopoietic stem cells originally residing in the bone marrow into the peripheral blood, and that the needed stem cells could be obtained by separating the blood components through a blood cell separator, a process known as hematopoietic stem cell mobilization. This is a milestone in the history of transplantation, and by harvesting mobilized peripheral blood hematopoietic stem cells, the risk of harvesting is greatly reduced compared to bone marrow harvesting.
Under normal physiological conditions, peripheral blood has a low number of hematopoietic stem cells, which can be increased 20 to 30 times by injection of the mobilizing agent granulocyte colony-stimulating factor.
After the mobilization injection, some donors or patients may experience varying degrees of back pain, headache, fatigue, loss of appetite, hypothermia, insomnia, etc. during the course of the injection, but these symptoms are usually mild, so be careful to drink plenty of fluids, and will usually resolve on their own 1 to 2 days after the hematopoietic stem cell collection. If the symptoms are more obvious, in order not to affect rest and sleep, analgesics can be given orally and symptomatic treatment can be given appropriately. Based on years of clinical observation, no serious and long-lasting harm to human health has been found so far at home and abroad.
In addition, it is advisable to eat a light diet during mobilization, avoiding oily foods such as fried eggs, fatty meats, frying, fish soup, bone broth, etc., to prevent the blood from containing too much fat and causing difficulties during stem cell transfusion back. You can eat calcium-rich foods such as milk and eggs, and take calcium tablets appropriately. Do not fast on the day of collection to avoid causing hypoglycemia.