nodgoРоссийский журнал детской гематологии и онкологии (РЖДГиО)Russian Journal of Pediatric Hematology and Oncology2311-12672413-5496LTD “Graphica”10.21682/2311-1267-2020-7-2-78-85nodgo-606Research ArticleОБЗОРЫ ЛИТЕРАТУРЫLITERATURE REVIEWSОптимизация методов сбора периферических гемопоэтических стволовых клеток у детей с онкологическими заболеваниями: обзор литературыOptimization of methods for collecting peripheral hematopoietic stem cells in children with cancer: literature reviewhttps://orcid.org/0000-0001-7939-5129СтепанянН. Г.StepanyanN. G.

Нара Гарегиновна Cтепанян, врач-трансфузиолог отдела афереза отделения детской трансплантации костного мозга и гемопоэтических стволовых клеток

Россия, 115478, Москва, Каширское шоссе, 23

G. Stepanyan: Transfusiologist Apheresis Department of the Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation

23 Kashirskoe Shosse, Moscow, 115478, Russia

nara19922@yandex.ruhttps://orcid.org/0000-0003-3797-5808СидороваН. В.SidorovaN. V.

заведующая отделением детской трансплантации костного мозга и гемопоэтических стволовых клеток

Россия, 115478, Москва, Каширское шоссе, 23

Head of the Department of Pediatric Bone Marrow and Hematopoietic Stem Cell Transplantation

23 Kashirskoe Shosse, Moscow, 115478, Russia

valerevna25@mail.ruhttps://orcid.org/0000-0002-1016-539XРубанскаяМ. В.RubanskayaM. V.

к.м.н., старший научный сотрудник 2-го хирургического отделения НИИ детской онкологии и гематологии

Россия, 115478, Москва, Каширское шоссе, 23

Cand. of Sci. (Med.), Researcher and Pediatric Oncologist Department of Surgery No. 2 Research Institute of Pediatric Oncology and Hematology

23 Kashirskoe Shosse, Moscow, 115478, Russia

https://orcid.org/0000-0003-3966-128XТупицынН. H.TupitsynN. N.

д.м.н., профессор, заведующий лабораторией иммунологии гемопоэза НИИ клинической онкологии им. Н.Н. Трапезникова

Россия, 115478, Москва, Каширское шоссе, 23

Dr. of Sci. (Med.), Professor, Head of the Laboratory of Hematopoiesis Immunology

23 Kashirskoe Shosse, Moscow, 115478, Russia

nntca@yahoo.comhttps://orcid.org/0000-0001-7805-5616МатинянН. В.MatinyanN. V.

д.м.н., профессор, заведующая отделением анестезиологии-реанимации НИИ детской онкологии и гематологии

Россия, 115478, Москва, Каширское шоссе, 23

Dr. of Sci. (Med.), Professor, Head of the Department of Anesthesiology and Resuscitation Research Institute of Pediatric Oncology and Hematology

23 Kashirskoe Shosse, Moscow, 115478, Russia

n9031990633@yandex.ruhttps://orcid.org/0000-0002-2945-284XКиргизовК. И.KirgizovK. I.

к.м.н., заместитель директора по научной и образовательной работе НИИ детской онкологии и гематологии

Россия, 115478, Москва, Каширское шоссе, 23

Cand. of Sci. (Med.), Deputy Director for Scientific and Educational Work of Research Institute of Pediatric Oncology and Hematology

23 Kashirskoe Shosse, Moscow, 115478, Russia

k.kirgizov@ronc.ruhttps://orcid.org/0000-0001-6131-1783ВарфоломееваС. Р.VarfolomeevaS. R.

д.м.н., профессор, заместитель директора по научной и лечебной работе – директор НИИ детской онкологии и гематологии аппарата управления

Россия, 115478, Москва, Каширское шоссе, 23

Dr. of Sci. (Med.), Professor, Deputy Director for Research and Clinical Work – Director of the Research Institute of Pediatric Oncology and Hematology

23 Kashirskoe Shosse, Moscow, 115478, Russia

s.varfolomeeva@ronc.ruФГБУ «НМИЦ онкологии им. Н.Н. Блохина» Минздрава РоссииРоссияN.N. Blokhin National Medical Research Centre of Oncology, Ministry of Health of RussiaRussian Federation202004072020727885Copyright © Степанян Н.Г., Сидорова Н.В., Рубанская М.В., Тупицын Н.H., Матинян Н.В., Киргизов К.И., Варфоломеева С.Р., 20202020Степанян Н.Г., Сидорова Н.В., Рубанская М.В., Тупицын Н.H., Матинян Н.В., Киргизов К.И., Варфоломеева С.Р.Stepanyan N.G., Sidorova N.V., Rubanskaya M.V., Tupitsyn N.N., Matinyan N.V., Kirgizov K.I., Varfolomeeva S.R.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://journal.nodgo.org/jour/article/view/606

Трансплантация аутологичных гемопоэтических стволовых клеток (ауто-ТГСК) является стандартом лечения онкологических, гематологических, а также некоторых иммунных заболеваний, обеспечивая восстановление показателей крови после высокодозной химиотерапии. У детей успех проведения мобилизации и обеспечение сбора гемопоэтических стволовых клеток (ГСК) особенно важен. Схемы мобилизации у детей решаются в индивидуальном порядке, что требует разработки и внедрения в практику рекомендаций по повышению эффективности мобилизации и сбора ГСК. Схемы мобилизации включают применение гранулоцитарного колониестимулирующего фактора в виде монотерапии или в сочетании с антагонистами CXCR4. Эти схемы оказываются неэффективными у некоторых детей, что требует повторной мобилизации или отказа от трансплантации, что негативно влияет на прогноз. При подготовке пациента к сбору ГСК необходимо учитывать всю предшествующую терапию, возраст пациента, массо-ростовые показатели, общее соматическое состояние. Заготовка необходимого количества ГСК позволит выполнить высокодозную терапию с последующей ауто-ТГСК и тем самым повысить эффективность лечения. Необходима оптимизация протокола мобилизации ГСК с большим уклоном на педиатрических пациентов, в котором будут чет- ко прописаны критерии проведения мобилизации, даны показания к данной процедуре и определены критерии технического сбора, что позволит добиться получения оптимального количества клеток CD34+, что обеспечит успех проводимого лечения.

Autologous hematopoietic stem cell transplantation (auto-HSCT) is a standard for the treatment of oncological, hematologic, and also some immune diseases, ensuring the restoration of blood counts after high-dose chemotherapy. In children, the success of mobilization and collection of hematopoietic stem cells (HSCs) is especially important. Mobilization schemes for children are decided on an individual basis, which requires the development and implementation of recommendations for improving the efficiency of mobilization and collection of HSCs. Mobilization schemes include the use of granulocyte colony-stimulating factor in the form of monotherapy or in combination with CXCR4 antagonists. These schemes are ineffective in some children, which requires re-mobilization or rejection of transplantation, which negatively affects the prognosis. When preparing a patient for HSCs collection, it is necessary to take into account all previous therapy, the patient’s age, weight and height indicators, and general somatic state. Harvesting the required amount of HSCs will allow for high-dose therapy followed by auto-HSCT, and thereby increase the effectiveness of treatment. It is necessary to optimize the protocol for mobilization of HSCs with a large bias for pediatric patients, which will clearly define the criteria for mobilization, give indications for this procedure and determine the criteria for technical collection, which will allow to obtain the optimal number of CD34+ cells, which will ensure the success of the treatment.

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The authors declare that there are no conflicts of interest present.