Abstract：
BACKGROUND: Factors such as age, underlying hematological disease, chemotherapy and radiotherapy used, and bone marrow infiltration may cause mobilization failure. Several preclinical observed that diabetes mellitus (DM) leads to profound remodeling of the hematopoietic stem cell (HSC) niche, resulting in the impaired release of HSCs. We aim to examine the effect of DM on HSC mobilization and to investigate whether there is a relationship between complications developing in the DM process and drugs used to treat DM and mobilization failure.
METHODS: In Erciyes University Bone Marrow Transplantation Unit, 218 patients who underwent apheresis for stem cell mobilization between 2011 and 2021 were evaluated retrospectively. One hundred and nine patients had a diagnosis of DM, and 109 did not.
RESULTS: Mobilization failure developed in 17 (15.6 %) of the patients in the DM group, while it developed in 7 (6.4 %) patients in the non-DM group (p = 0.03). CD34+ stem cell count was 8.05 (1.3-30.2) × 106/kg in the DM group, while it was 8.2 (1.7-37.3) × 106/kg in the other group (p = 0.55). There was no statistically significant relationship between glucose and hemoglobin A1c levels and the amount of CD34+ cells (p = 0.83 and p = 0.14, respectively). Using sulfonylurea was the only independent predictor of mobilization failure (OR 5.75, 95 % CI: 1.38-24.05, p = 0.02).
CONCLUSIONS: DM should be considered a risk factor for mobilization failure. Further research is needed fully to understand the mechanisms underlying the mobilization failure effects of sulfonylureas and to develop strategies to improve stem cell mobilization in diabetic patients.
METHODS: In Erciyes University Bone Marrow Transplantation Unit, 218 patients who underwent apheresis for stem cell mobilization between 2011 and 2021 were evaluated retrospectively. One hundred and nine patients had a diagnosis of DM, and 109 did not.
RESULTS: Mobilization failure developed in 17 (15.6 %) of the patients in the DM group, while it developed in 7 (6.4 %) patients in the non-DM group (p = 0.03). CD34+ stem cell count was 8.05 (1.3-30.2) × 106/kg in the DM group, while it was 8.2 (1.7-37.3) × 106/kg in the other group (p = 0.55). There was no statistically significant relationship between glucose and hemoglobin A1c levels and the amount of CD34+ cells (p = 0.83 and p = 0.14, respectively). Using sulfonylurea was the only independent predictor of mobilization failure (OR 5.75, 95 % CI: 1.38-24.05, p = 0.02).
CONCLUSIONS: DM should be considered a risk factor for mobilization failure. Further research is needed fully to understand the mechanisms underlying the mobilization failure effects of sulfonylureas and to develop strategies to improve stem cell mobilization in diabetic patients.
摘要：
背景：年龄等因素，潜在的血液病，化疗和放疗，骨髓浸润可能导致动员失败。一些临床前观察到糖尿病（DM）导致造血干细胞（HSC）生态位的深刻重塑，导致HSC的释放受损。我们旨在研究DM对HSC动员的影响，并研究DM过程中出现的并发症与用于治疗DM和动员失败的药物之间是否存在关系。
方法：在Erciyes大学骨髓移植单元，对2011年至2021年间接受单采术进行干细胞动员的218例患者进行了回顾性评估。109名患者被诊断为DM，109没有。
结果：DM组17例（15.6%）患者出现动员失败，而在非DM组中有7例（6.4％）患者出现（p=0.03）。DM组CD34+干细胞计数为8.05(1.3-30.2)×106/kg,而另一组为8.2（1.7-37.3）×106/kg（p=0.55）。在葡萄糖和血红蛋白A1c水平与CD34+细胞的数量之间没有统计学上显著的关系(分别为p=0.83和p=0.14)。使用磺酰脲是动员失败的唯一独立预测因子（OR5.75，95％CI：1.38-24.05，p=0.02）。
结论：DM应被视为动员失败的危险因素。需要进一步的研究来充分了解磺脲类药物动员失败效应的潜在机制，并制定改善糖尿病患者干细胞动员的策略。
方法：在Erciyes大学骨髓移植单元，对2011年至2021年间接受单采术进行干细胞动员的218例患者进行了回顾性评估。109名患者被诊断为DM，109没有。
结果：DM组17例（15.6%）患者出现动员失败，而在非DM组中有7例（6.4％）患者出现（p=0.03）。DM组CD34+干细胞计数为8.05(1.3-30.2)×106/kg,而另一组为8.2（1.7-37.3）×106/kg（p=0.55）。在葡萄糖和血红蛋白A1c水平与CD34+细胞的数量之间没有统计学上显著的关系(分别为p=0.83和p=0.14)。使用磺酰脲是动员失败的唯一独立预测因子（OR5.75，95％CI：1.38-24.05，p=0.02）。
结论：DM应被视为动员失败的危险因素。需要进一步的研究来充分了解磺脲类药物动员失败效应的潜在机制，并制定改善糖尿病患者干细胞动员的策略。
