The source of cells for allografting

Peripheral blood is used almost exclusively as the source of hematopoietic cells for autografting, but the best source of cells for allografting is the subject of considerable discussion and debate. Randomized studies comparing unstimulated bone marrow with G-CSF-mobilized peripheral blood in the sibling allogeneic setting have indicated a trend to more chronic graft-versus-host disease in peripheral blood recipients. However, whether the use of G-CSF-mobilized peripheral blood cells leads to more acute graft-versus-host disease is uncertain. Adults undergoing sibling allografting appear to benefit in terms of improved disease-free survival or improved overall survival with the use of G-CSF-mobilized peripheral blood. It is not clear, however, whether these benefits also extend to children or those undergoing matched unrelated transplantation. (C) 2003 American Society for Blood and Marrow Transplantation