Peripheral blood stem cell transplants.

Autologous peripheral blood stem cell transplantation High dose myeloablative treatment followed by autologous haemopoietic stem cell rescue is increasingly used in the treatment of haematological malignancies and solid tumours with the aim of achieving a dose–response eVect. Apart from the risk of disease relapse, the major drawback of this approach is the risk of procedure related toxicity reflecting the period of pancytopenia. The past decade has witnessed a number of important advances in the field of autologous transplantation with a resultant reduction in this toxicity. The most important of these has been the gradual switch to peripheral blood as a source of haemopoietic stem cells. This has not only led to a profound acceleration in haemopoietic reconstitution, but has also extended the indications of autologous transplantation to situations in which autologous bone marrow transplantation would not have been considered because of toxicity. In view of these advantages, it is no surprise that the use of peripheral blood as a source of haemopoietic progenitors has almost replaced bone marrow in the autologous setting, increasing from 15% of all European autologous transplants in 1991 to 79% in 1995.