Peripheral blood progenitor cell or bone marrow transplantation: Controversy remains

PURPOSE OF REVIEW: The paper compares bone marrow and peripheral blood progenitor cell transplantations in the allogeneic setting. RECENT FINDINGS: Peripheral blood progenitor cell use has emerged as an international standard of care for hematopoietic transplantation. These cells have a different cellular composition including higher numbers of CD34 cells and markedly higher numbers of T lymphocytes. Current data support the general safety of this approach for normal transplant donors. Results consistently indicate more rapid hematopoietic recovery compared with bone marrow transplantation. This may result in improved early survival in adults with high-risk leukemias, but longer follow-up has demonstrated an increased rate of chronic graft-versus-host disease morbidity and mortality which may obviate the long-term benefit. SUMMARY: It is unclear whether peripheral blood progenitor cell or bone marrow transplantation will produce improved disease-free or overall survival. Additional studies with long-term follow-up are necessary to resolve these controversies.