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Bone Marrow Transplantation And Peripheral Blood Stem Cell Transplantation Scholarly Journal | Open Access Journals
Transplantation Technologies & Research

Transplantation Technologies & Research

ISSN: 2161-0991

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Bone Marrow Transplantation And Peripheral Blood Stem Cell Transplantation Scholarly Journal

In the early days of allogeneic hematopoietic stem cell transplantation, the only source of transplant available was bone marrow from the donor pelvis under anesthesia. When studies have shown that an increased dose of bone marrow cells is correlated with more robust hematopoietic transplantation and lower mortality from infectious complications, transplant centers have started using peripheral blood stimulated by filgrastim , which has a much higher blood progenitor cell content than bone marrow, although it was feared that the higher T cell content would increase the risk of graft-against-host disease (GVHD) .1-5 Several large randomized trials of identical HLA siblings have shown that peripheral blood stem cells result in better transplants but increased the risk of acute and chronic GVHD.4-11 Some studies have shown a decrease in the relapse rate and better survival with peripheral blood stem cells, compared to bone marrow, especially in patients with ca High risk blood cell ncers. However, results obtained with transplants of identical HLA siblings may not be applicable to transplants from unrelated donors, given the greater genetic diversity and, therefore, the higher risk of GVHD in the unrelated recipient, even if the donor and the recipient are fully HLA-matched.

 

Over the past decade, the use of peripheral blood stem cells has increased and now accounts for 75% of stem cell transplants from unrelated adult donors, with no clinical data to support this change.12 A large study observational transplant from unrelated donors showed higher rates of acute and chronic GVHD with peripheral blood stem cells than with bone marrow and no improvement in survival.13 To determine the effects of the transplant source for transplants from unrelated donors, we performed a randomized trial comparing the results of peripheral blood strains - cell and bone marrow transplants.

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