Peripheral Blood or Bone Marrow Stem Cells? Practical Considerations in Hematopoietic Stem Cell Transplantation

Although peripheral blood stem cells (PBSC) have worldwide become the predominant source of progenitor cells for hematopoietic stem cell transplantation (HSCT), debate about their role compared with bone marrow (BM) has recently intensified, in large part based on the results of a multicenter Clinic...

Full description

Saved in:
Bibliographic Details
Published in:Transfusion medicine reviews 2019-01, Vol.33 (1), p.43-50
Main Authors: Amouzegar, Afsaneh, Dey, Bimalangshu R., Spitzer, Thomas R.
Format: Article
Language:English
Subjects:
Bone marrow
Donor stem cell source
Graft-versus-host disease
Hematopoietic stem cell transplantation
Peripheral blood stem cells
Citations: Items that this one cites
Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:Although peripheral blood stem cells (PBSC) have worldwide become the predominant source of progenitor cells for hematopoietic stem cell transplantation (HSCT), debate about their role compared with bone marrow (BM) has recently intensified, in large part based on the results of a multicenter Clinical Trials Network study which showed lower incidence of chronic graft-versus-host disease (cGVHD) and improved quality of life in recipients of myeloablative HLA-matched unrelated BM compared with PBSC transplants. However, in certain patient populations, PBSC may lead to improved clinical outcomes due to faster hematologic recovery, a lower risk of graft failure, and possibly a lower probability of relapse. This review will provide a comprehensive summary of studies comparing PBSC with BM as the graft source in terms of acute and chronic GVHD incidence, time to engraftment, and disease-free and overall survival probabilities after HLA-matched related and unrelated donor transplantation and haploidentical donor transplantation. Recommendations based on these studies regarding the use of PBSC versus BM for HSCT are offered. •PBSCT is associated with higher incidence of cGVHD in HLA-matched unrelated donor setting.•BM may be the preferred source of progenitor cells in HLA-matched unrelated donor transplantation.•PBSC is an acceptable source of stem cells in HLA-matched related donor transplantation.•Novel graft engineering methods to reduce cGVHD incidence after PBSCT should be further studied.
ISSN:0887-7963
1532-9496
DOI:10.1016/j.tmrv.2018.11.003