Kessinger A, Armitage J, Bierman P, Bishop M, Joshi S, Reed E, Sharp G, Talmadge J, Vose J
Department of Internal Medicine, University of Nebraska Medical Center, Omaha 68198-3330.
Med Oncol. 1994;11(2):43-6. doi: 10.1007/BF02988829.
Two clinical results of peripheral blood stem cell support are commonly considered: (1) the effect on hematopoietic recovery and (2) the effect on the underlying malignancy. The dynamics of hematopoietic recovery after autologous bone marrow transplantation and after autologous peripheral blood stem cell transplantation in a clinical setting are similar if no exogenous cytokines are administered and the peripheral stem cells are collected while their numbers are not deliberately increased (mobilised). If mobilized peripheral stem cells are transplanted, hematopoietic recovery is accelerated. In some circumstances, patients who receive peripheral stem cell transplantation may experience an improved progression-free survival after high-dose therapy when compared with similar patients who receive autologous bone marrow transplantation. Explanations for such a survival advantage might include (1) a lower likelihood of occult tumor cells capable of restoring disease in peripheral stem cell autograft products than in bone marrow harvests, (2) a greater number of cytotoxic effector cells capable of destroying occult tumor cells in the peripheral stem cell collections than in bone marrow harvests, and (3) a different and advantageous pattern of immunologic recovery following autologous peripheral stem cell transplant compared to autologous bone marrow transplant.
（1）对造血恢复的影响，以及（2）对潜在恶性肿瘤的影响。在临床环境中，如果不给予外源性细胞因子，并且外周干细胞在数量未被刻意增加（动员）的情况下进行采集，那么自体骨髓移植后和自体外周血干细胞移植后的造血恢复动态是相似的。如果移植动员的外周干细胞，造血恢复会加速。在某些情况下，与接受自体骨髓移植的类似患者相比，接受外周干细胞移植的患者在高剂量治疗后可能会有更好的无进展生存期。这种生存优势的解释可能包括：（1）与骨髓采集物相比，外周干细胞自体移植产品中能够恢复疾病的隐匿肿瘤细胞的可能性更低；（2）与骨髓采集物相比，外周干细胞采集中能够破坏隐匿肿瘤细胞的细胞毒性效应细胞数量更多；（3）与自体骨髓移植相比，自体外周血干细胞移植后免疫恢复的模式不同且具有优势。
