Allogeneic bone marrow transplantation now has an established place in the treatment of severe aplastic anemia and acute leukemia. Major problems to be overcome in transplantation in patients with aplastic anemia are marrow graft rejection and graft vs. host disease.
Full Answer
Allogeneic bone marrow transplantation (BMT) is performed as curative therapy for hematological malignancy and bone marrow failure syndromes, and despite advances in the field it still carries a high treatment-related mortality, largely attributable to graft-versus-host disease (GVHD).
Several studies indicate that PBSCs confer survival advantages over bone marrow with matched sibling donors for most disease categories except where the risks of disease recurrence within the first year are low, but with the extra risk of more chronic graft-versus-host disease (GVHD).
Early studies suggest that filgrastim-stimulated bone marrow may confer some of the advantages of PBSCs without the risks of chronic GVHD. Summary: PBSCs are a preferred source of stem cells for many types of allogeneic transplant, in which matched related donors are available.
Summary: PBSCs are a preferred source of stem cells for many types of allogeneic transplant, in which matched related donors are available. Whether the same benefits accrue from unrelated donors will require further follow-up.