Optimization of peripheral blood stem cell collection.
Peripheral blood stem cells are increasingly used in lieu of marrow for hematopoietic support because of ease of collection and the rapid kinetics of recovery relative to bone marrow transplantation. More recently, it has been shown that adequate numbers of peripheral blood stem cells can be collected using growth factors alone without prior chemotherapy. By measuring CD34 or granulocyte-macrophage colony-forming unit content of peripheral blood stem cell collections, mobilization technique, age, marrow disease, prior radiation, and prior chemotherapy regimens have been found to be important factors influencing the numbers of stem cells collected. However, interpatient variation in CD34 collections remains high and there are subgroups of heavily pretreated patients who will fail to mobilize sufficient numbers of stem cells to ensure rapid engraftment. The current challenge for clinical investigations is to improve methods for identifying such patients prior to collection and utilize new strategies for stem cell mobilization. The relative ease of collection and the rapid engraftment after myeloablative therapy suggest that peripheral blood stem cells will likely supplant marrow for both allogeneic and autologous transplantation in the next 5 years.
Demirer
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T
Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Bensinger
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WI
D000970:Antineoplastic Agents / Q000627:therapeutic use; D001782:Blood Donors; D001800:Blood Specimen Collection / Q000592:standards*; D016207:Cytokines / Q000627:therapeutic use; D006133:Growth Substances / Q000627:therapeutic use; D019650:Hematopoietic Stem Cell Mobilization; D006412:Hematopoietic Stem Cells; D006801:Humans
D000970:Antineoplastic Agents; D016207:Cytokines; D006133:Growth Substances