Immunomodulatory Agents and Factors in Poor Hematopoietic Stem Cell Mobilization: Current Strategies and Future Prospects

Abstract

Hematopoietic stem cell (HSC) mobilization is a critical step in bone marrow transplantation for treating hematological malignancies and other disorders. Since poor mobilization affects 10–20% of patients, it can cause failure of the transplant and complications in clinical outcomes. There are several important factors that modify poor mobilization, of which immunomodulatory agents and factors are most potentially causative. This study examines the role of immunomodulatory factors in the process of HSC mobilization from the bone marrow. It presents a prospect based on the latest preclinical studies and clinical trials. We explore standard agents, such as granulocyte colony-stimulating factor (G-CSF) and plerixafor, alongside emerging immunomodulatory cytokines, including interleukin-8 (IL-8) and interleukin-1 (IL-1), and their impact on the bone marrow (BM) niche. Strategies to enhance mobilization in poor responders, including combination therapies and niche-targeting approaches, are critically assessed. Looking forward, we propose innovative prospects, such as epigenetic reprogramming, nanotechnology-based delivery, and artificial intelligence (AI)-driven personalization, to address current gaps and improve mobilization efficacy. This article aims to guide future research and clinical practice in optimizing HSC transplantation.