Hematopoietic stimulants in the treatment and prevention of graft-versus-host disease

Abstract

Conditioning regimens prior to hematopoietic stem cell transplantation (HSCT) are often accompanied by a period of aplasia characterized by severe neutropenia, anemia, and thrombocytopenia. Long-term antibacterial and immunosuppressive therapy in patients with graft-versus-host disease (GVHD) exacerbates hematopoietic depression. Colony-stimulating factors, erythropoietins, and thrombopoietin receptor agonists are used to correct hematological dysfunction in these patients. However, these drugs have side effects, and their stimulating effect, as a rule, is limited to one of the hematopoietic lineages. At the same time, in patients after HSCT, for the prevention and treatment of hematopoietic disorders against the background of GVHD, it is necessary to use drugs that promote the restoration of all hematopoietic cell lines. Inducers of Toll- and NOD-like receptors, stimulators of emergency hematopoiesis, can be considered as promising drugs for this category of patients. These compounds include bacterial derivatives and sulfated poly(oligo)saccharides capable of stimulating hematopoiesis, which allows us to consider them as promising stimulants of hematopoiesis for the treatment and prevention of disorders of the immune status and hematopoiesis in GVHD.