chapter  14
11 Pages

Autologous and Allogeneic Transplantation with Blood CD34 Cells: A Pediatric Experience

ByYoshifumi Kawano, Yoichi Takaue, Tsutomu Watanabe, Yasuhiro Okamoto, Takanori Abe, Yasuhiro Kuroda, Arata Watanabe

In bone marrow transplantation (BMT), only hematopoietic stem cells (HSCs) that exist in the iliac bone can be collected by aspiration under general anesthesia. However, hematopoietic activity in this area decreases with age, which very often makes the procedure inefficient. On the other hand, collection of peripheral blood stem cells (PBSCs) does not require anesthesia or multiple marrow aspirations and, hence, is far less invasive than bone marrow collection. Most importantly, PBSCs can be collected from the body’s entire pool of HSCs to provide more stem cells than bone marrow aspiration performed at localized iliac bones; this leads to the faster recovery of hematopoiesis after PBSC transplantation (PBSCT) than after BMT and makes ‘‘cell component therapy’’ far more effective with PBSCs. Accordingly, insurance reimbursement policy has been cleared for PBSCT

since 1994, and this has become an accepted treatment modality for a variety of malignant disorders in Japan.