chapter  27
22 Pages

Autologous Peripheral Blood Stem Cell Collection and Engraftment

ByStefan Hohaus, Maria Teresa Voso, Simona Martin, Rainer Haas

I. INTRODUCTION Efficient mobilization and collection of hematopoietic stem cells (HSCs) from peripheral blood are a prerequisite for a successful peripheral blood stem cell (PBSC) transplantation. Provided that a sufficient number of autologous or allogeneic PBSCs are transplanted, the major advantage of PBSCs compared with bone marrow (BM) is the shortened period of severe cytopenia following high-dose therapy (1,2). Bone marrow has therefore been gradually replaced by mobilized peripheral blood (PB) as a source of HSCs. Circulation of progenitor cells capable of forming granulocytic and monocytic colonies was first observed in 1970 (3). The concentration of these colony-forming units (CFUs) was only 1-10% of that observed in BM. In 1976, Richman et al. found that, in patients with solid tumors, the concentration of circulating CFUs increased up to 20-fold over baseline levels during leukocyte recovery after cytotoxic chemotherapy (4). The introduction of hematopoietic growth factors (HGFs) in the late 1980s resulted in a further significant increase of PBSCs when administered either following cytotoxic chemotherapy or during steadystate hematopoiesis.