Peripheral blood stem cell versus bone marrow allotransplantation:: does the source of hematopoietic stem cells matter?

Hematopoietic stem cells from 4 different sources have been or are being used for the reconstitution of lymphohematopoietic function after myeloablative, near-myeloablative, or non-myeloalblative treatment. Bone marrow (BM)-derived stem cells, introduced by E. D. Thomas in 1963,(1) are considered the classical stem cell source. Fetal liver stem cell transplantation has been performed on a limited number of patients with aplastic anemia or acute leukemia, but only transient engraftment has been demonstrated.(2) Peripheral blood as a stem cell source was introduced in 1981,(3) and cord blood was introduced as a source in 1988.(4) The various stem cell sources differ in their reconstitutive and immunogenic characteristics, which are based on the proportion of early pluripotent and self-renewing stem cells to lineage-committed late progenitor cells and on the number and characteristics of accompanying accessory cells contained in stem cell allografts. (C) 2001 by The American Society of Hematology.