Bone marrow transplants from peripheral blood

BMJ 1994;309:4-5 (2 July)

Editorials

Bone marrow transplants from peripheral blood

Treating malignant disease with very high dose chemotherapy,often with total body irradiation, has become established duringthe past decade, particularly for lymphomas and leukaemias.Reinfusion of some of the patient's bone marrow (collected beforehigh dose chemotherapy) has improved the outcome of these veryintensive regimens. These autologous bone marrow transplants(autografts) entail about four weeks' pancytopenia,¹ and despiteimprovements in supportive care this procedure is associatedwith substantial morbidity and a 5-10% mortality, mainly dueto myelosuppression.

Normal bone marrow contains enough undifferentiated stem cellsto allow long term reconstitution (engraftment), but it seemsto lack those more committed progenitors that would lead toengraftment within two or three weeks. In the past few yearsit has become possible to collect such committed progenitorand stem cells not from wihin the bone marrow cavity but fromperipheral blood. The use of peripheral blood stem cells asautografts has . . . [Full text of this article]

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Contamination of bone marrow transplants from peripheral blood: M Farrington, I Matthews, R Marcus, M A Scott, E Caffrey, and C J Hunt
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