Peripheral blood stem cell autografting

Abstract

Transplantation of haemopoietic stem cells provides a means whereby patients with malignant disease may be treated with increased doses of chemotherapy or chemoradiotherapy. Until recently, the bone marrow has been the sole source of these cells. However, haemopoietic progenitors can also be demonstrated in the blood and it has been known for more than twenty years that peripheral blood mononuclear cells are capable of repopulating the marrow in animals. This phenomenon has recently been reproduced in man. The use of peripheral blood rather than bone marrow for autologous stem cell rescue may have advantages in terms of ready access, availability in patients with compromised pelvic bone marrows, a lower risk of tumour contamination and more rapid granulocyte and immune recovery. However, clinical experience with peripheral blood stem cell autografting is still very small. This review discusses the characteristics of circulating stem cells, the methods by which they can be collected and stored and the information which has come from recent studies of their transplantation in man.

Peripheral blood stem cell mobilization in multiple myeloma: Growth factors or chemotherapy?

“…Transient circulation of PBSC occurs during the recovery phase of chemotherapy-induced pancytopenia[ 22 , 49 , 50 ] and is augmented by growth factor support[ 22 ] (Table 2 ). This process, chemomobilization (CM), provides not only higher cell yields than G-CSF alone, but also affords anti-myeloma activity[ 32 , 51 - 54 ].…”

Culture of colony-forming hematopoietic progenitor cells from human peripheral blood

“…Autologous transplantation of PB HSC has been used to reconstitute hematopoiesis in patients with various forms of malignant diseases after intensive cytoreduction therapy (1,10,12). One report has shown that allogeneic transplantation of PB HSC can also provide engraftment (11).…”

Bone Marrow Transplantation

“…Immune problems (donor availability, graftversus-host disease, GvHD) and scarcely elucidated but undisputably favourable effects (graft-versus-Ieukaemia, GvL) dominate the allogeneic setting, while in the autologous one elimination of the residual leukaemic clonogenic cells in the remission marrow is a major problem. However, the utilisation of peripheral HSCs is gradually becoming a procedure of major importance, especially when they are collected in the overshoot waves associated with haemopoietic reconstitution following myelosuppressive chemotherapy [1][2][3][4][5], where contamination with residual leukaemic cells is even less than in the marrow [6]. The successful utilisation of non-clonal HSCs, grown in and harvested from long-term cultures of marrows of patients with acute myeloid leukaemia (AML), has also been reported [7].…”