How beneficial is the use of NSAIDs in stem-cell transplantation?

For a number of malignant hematologic diseases, including leukemias, lymphomas and myelomas, hematopoietic stem cell transplantation remains the only curative option. The stem cell sources for these life-saving transplants come from bone marrow, umbilical cord blood, or from the peripheral blood of patients or donors treated with mobilizing agents. Recently, the use of nonsteroidal anti-inflammatory drugs (NSAIDs) including aspirin, ibuprofen and meloxicam has been reported to enhance the ability to acquire stem cells from mobilized peripheral blood, resulting in a superior stem cell graft. The addition of NSAIDs, notably meloxicam, to current mobilization strategies is convenient, cost effective, and given the long track record of NSAID use, presumably safe. This article discusses the potential to translate these findings to clinical practice and addresses unanswered questions regarding the use of NSAIDs in stem cell transplantation.