The Rationale for not Routinely Purging Autologous Blood Stem Cell Grafts

The desire to remove tumor cells from autologous grafts is strong and commitments to this approach for ASCT have reached religious proportions. There is a general "feeling" by many investigators, the public and some private companies that grafts should be purged "if it does no harm and could do some good". However, it can be concluded after more than a decade of intensive research, that no current purging technology is standard of care for patients receiving ASCT. In-vitro demonstration of tumor cell removal from the graft is not an acceptable criterium for judging efficacy of purging as all techniques could be harmful to the patient by altering the hematologic and/or immunologic function of the graft. Purging technologies should not be utilized clinically in a non-research setting until documented to be safe and effective in randomized trials.