- T L Holyoake,
- I M Franklin
Treating malignant disease with very high dose chemotherapy, often with total body irradiation, has become established during the past decade, particularly for lymphomas and leukaemias. Reinfusion of some of the patient's bone marrow (collected before high dose chemotherapy) has improved the outcome of these very intensive regimens. These autologous bone marrow transplants (autografts) entail about four weeks' pancytopenia,1 and despite improvements in supportive care this procedure is associated with substantial morbidity and a 5–10% mortality, mainly due to myelosuppression.
Normal bone marrow contains enough undifferentiated stem cells to allow long term reconstitution (engraftment), but it seems to lack those more committed progenitors that would lead to engraftment within two or three weeks. In the past few years it has become possible to collect such committed progenitor and stem cells not from wihin the bone marrow cavity but from peripheral blood. The use of peripheral blood stem cells as autografts has changed much of haematological practice and will transform medical oncology within the next few years.
Until 1984, the stem cell content of either bone marrow or peripheral blood could be estimated only indirectly by in vitro colony forming assays. Since then a monoclonal antibody, now …
Sign in
Personal subscribers, sign in here:
Article access
Article access for 1 day
Purchase this article for £20 $30 €32*
The PDF version can be downloaded as your personal record
CiteULike
Connotea
Del.icio.us
Digg
Facebook
Reddit
Technorati
Twitter
Stumbleupon
Rapid responses
Latest Responses
The decline in the breast cancer incidence is 1.2% and it is not significant.
Published 10 February 2012
'twas ever thus
Published 10 February 2012
The value of historic human remains
Published 10 February 2012
In Praise of British Literature
Published 10 February 2012
Is real shared decision making possible?
Published 10 February 2012
Most responses
Does anyone understand the government’s plan for the NHS? (17 responses)
Published 17 Jan 2012
Bad medicine: medical nutrition (15 responses)
Published 18 Jan 2012
Shared decision making: really putting patients at the centre of healthcare (7 responses)
Published 27 Jan 2012
Why legislation is necessary for my health reforms (7 responses)
Published 1 Feb 2012
Search for evidence goes on (5 responses)
Published 17 Jan 2012