Corey Cutler

Stem Cell Sources

The discovery that human hematopoietic progenitors are found in the peripheral circulation and can be harvested for use in stem cell transplantation (SCT) has been both a scientifically enlightening and a clinically useful observation in SCT technology. Over the past decade, our understanding of peripheral blood stem cell (PB SC) properties has increased dramatically, and as a consequence, the use of PBSCs in autologous and allogeneic transplantation has increased exponentially. PBSCs have rapidly become the stem cell of choice for nearly all patients undergoing autologous transplantation because of their ease of collection and rapid engraftment. In the allogeneic setting, there have been dramatic increases in the use of PBSCs; however, many centers do not yet have adequate facilities to collect PBSCs from allogeneic donors and some centers have chosen not to adapt PBSCs as the main source for allogeneic stem cells for a variety of reasons. In the autologous setting, the broad adoption of peripheral blood stem cell transplantation (PBSCT) has been beneficial, with more rapid time to engraftment and less in-hospital morbidity noted after transplant. In the allogeneic setting, however, these data are less mature and there are observations that suggest that some of the putative advantages of PBSCT in the allogeneic setting may have substantial limitations.