Peripheral Blood or Bone Marrow stem cells?

Introduction: Over the past decade, the use of peripheral blood stem cells has increased, and now about 75% of unrelated living donor transplants are performed using peripheral blood stem cells without supportive data in the unrelated donor setting. This trend is called into question by results of a large phase III randomized multicenter trial showing similar outcomes of transplant procedures with bone marrow and peripheral blood stem cells from unrelated donors. Although use of peripheral blood stem cells resulted in better engraftment, the rates of chronic and more extensive graft-vs-host disease were higher.Description: In the context of this overview, 18articles were used between the years 2010 through the end of 2018 using the Keywords of PubMed, Google scholar search engines.Discussion and conclusion: Peripheral blood stem cells are currently being used by many centers as a source of adult stem cells because clinical trials of this strategy in related donors have shown lower relapse rates, better engraftment, and increased survival in patients with advanced leukemia and other blood diseases compared with the use of bone marrow stem cells. Peripheral blood stem cells (PBSC) collected after mobilization with granulocyte colony stimulating factor (G-CSF) contain a larger number of CD34-positive (CD34) progenitors and total cells than bone marrow. These observations led to the hypothesis that transplantation of PBSC would lead to lower mortality compared to transplantation of marrow. In addition, PBSC grafts have a higher T cell content, predicting a possibly more powerful anti-leukemia effect. However, the higher T cell content of PBSC may also lead to increased incidence and severity of acute and chronic graft-versus-host disease (GVHD).