Blood cell transplantation.

Blood cell transplantation (BCT) is the procedure of choice for autologous bone marrow transplantation. In this paper we review the current status of BCT with emphasis on important recent advances. These include increasing knowledge of the biologic nature of mobilized blood cells and important evidence showing that very primitive cells are present in blood cells. An increasing understanding of mechanisms of mobilization is likely to result in the design of more rational mobilization strategies. Current mobilization methods are discussed including justification of combined chemotherapy and cytokine mobilization as the method of choice for cancer patients. Single-apheresis BCT may be possible in the future. Recent data show variable malignant contamination of blood cell harvests, but whether this contributes to relapse is unknown. Clinical applications and the efficacy of high-dose therapy are discussed. BCT may allow novel approaches to increase both total dose and dose intensity of therapy as well as application to allogeneic transplantation.