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Related Experiment Videos

Innovations in allogeneic stem-cell transplantation.

J F DiPersio1, H Khoury, J Haug

  • 1Division of Bone Marrow Transplantation and Stem Cell Biology, Washington University School of Medicine, St Louis, MO 63110, USA.

Seminars in Hematology
|March 16, 2000
PubMed
Summary

Cytokine-mobilized peripheral blood progenitor cells (PBPC) offer a safer alternative to bone marrow transplantation (BMT), reducing infection and bleeding risks. PBPC transplantation with minimal conditioning significantly lowers fever and transfusion needs post-transplant.

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Single institution experience with G-CSF mobilized T-cell replete haploidentical hematopoietic cell transplantation.

Bone marrow transplantation·2017

Area of Science:

  • Hematology
  • Transplantation immunology
  • Cellular therapy

Background:

  • Allogeneic bone marrow transplantation (BMT) carries risks of prolonged neutropenia and thrombocytopenia, increasing infection and bleeding complications.
  • Cytokine-mobilized peripheral blood progenitor cells (PBPC) are being explored as a potentially safer alternative to BMT.

Purpose of the Study:

  • To evaluate PBPC mobilization and transplantation in patients with high-risk hematologic malignancies.
  • To assess the efficacy of different cytokine regimens for PBPC mobilization.
  • To compare engraftment and GvHD rates between PBPC transplantation and BMT.

Main Methods:

  • Studied PBPC mobilization and transplantation in over 150 patients with high-risk hematologic malignancies.
  • Utilized granulocyte colony-stimulating factor (G-CSF) and granulocyte-macrophage colony-stimulating factor (GM-CSF) for PBPC mobilization.

Related Experiment Videos

  • Analyzed CD34+ cell counts for predicting mobilization success and assessed engraftment and graft-versus-host disease (GvHD) rates post-transplantation.

    • Main Results:

    • G-CSF effectively mobilized PBPC, with 91% of donors yielding >2 x 10(6) CD34+ cells/kg per apheresis.
    • Combination G-CSF and GM-CSF showed superior mobilization compared to G-CSF alone.
    • PBPC transplantation demonstrated faster engraftment than BMT, with similar safety regarding acute GvHD, but higher chronic GvHD rates.
    • An additional PBPC infusion shortened neutropenia and thrombocytopenia.
    • Minimal conditioning regimens combined with PBPC transplantation nearly eliminated fever, neutropenia, and transfusion requirements.

    Conclusions:

    • PBPC transplantation is a viable and potentially safer alternative to BMT for high-risk hematologic malignancies.
    • PBPC mobilization strategies can be optimized using pre-mobilization CD34+ cell counts.
    • Innovative approaches including PBPC transplantation and minimal conditioning significantly improve post-transplant outcomes, reducing complications and supportive care needs.