Autologous transplantation with peripheral blood stem cells: a review of clinical results.

Hematopoietic stem cells circulating in the peripheral blood of patients with malignancies have been collected by apheresis and cryopreserved. Following administration of marrow-lethal cancer therapy, the autologous cells were infused intravenously resulting in recovery of marrow hematopoietic function. Circulating stem cells have been collected in two clinical settings: 1) while their numbers were expanded during accelerated hematopoiesis and 2) while no efforts to increase their circulating numbers were made. Both techniques collected stem cells that produced durable engraftment following transplantation, but cells collected during accelerated hematopoiesis produced earlier engraftment. Autologous peripheral stem cell transplantation permits patients with refractory malignancies and marrow abnormalities that preclude autologous marrow transplantation to receive marrow-ablative therapy. A review of the clinical outcome of patients treated at our institution and at other centers with high-dose therapy and autologous peripheral stem cell transplantation showed that complete remissions occurred for some patients with Hodgkin's disease, non-Hodgkin's lymphoma, acute myelogenous leukemia, and multiple myeloma. Continued follow-up will determine if cures have resulted.