Kessinger A, Armitage J O
Important Adv Oncol. 1993:167-75.
Blood-derived stem cells are a functionally equivalent alternative to marrow-derived stem cells when autotransplanted to restore hematopoiesis that has been iatrogenically ablated. This alternate source of stem cells is particularly useful for patients who are candidates for marrow-ablative therapy and who also have bone marrow abnormalities that make it an unsuitable product for transplantation. When autologous blood-derived stem cells that were collected while their numbers were deliberately expanded in the circulation (mobilized) are transplanted, the resultant recovery of marrow function is very rapid. Because autologous bone marrow transplantation alone cannot result in hematopoietic recovery that is as rapid, peripheral stem cells have been preferred to bone marrow for autografting in some patients. This early recovery involves not only granulocytes but also platelets and red cells. Currently available cytokines administered at the time of ABMT usually facilitate only rapid granulocyte recovery. Emerging studies indicate that other consequential benefits of peripheral stem cell infusion that have not yet been fully recognized may exist. If, ultimately, techniques are developed that produce optimal stem cell mobilization for every eligible patient, then perhaps peripheral stem cell collections can be completed in 1 to 2 days. These cells could be used to minimize or ameliorate the hematopoietic toxicity associated with myelotoxic therapy. Perhaps then the technique eventually will become a routine adjunct to chemotherapy administration.
自体移植以恢复医源性消融的造血功能时，血液来源的干细胞在功能上等同于骨髓来源的干细胞。这种替代的干细胞来源对于那些适合进行骨髓清除疗法但同时又存在骨髓异常而使其骨髓不适合用于移植的患者特别有用。当移植在循环中数量被特意扩增（动员）时采集的自体血液来源干细胞时，骨髓功能的恢复非常迅速。由于仅进行自体骨髓移植不能带来如此快速的造血恢复，因此在一些患者的自体移植中，外周干细胞比骨髓更受青睐。这种早期恢复不仅涉及粒细胞，还涉及血小板和红细胞。目前在自体骨髓移植时使用的细胞因子通常仅有助于粒细胞的快速恢复。新出现的研究表明，外周干细胞输注可能还存在其他尚未被充分认识的重要益处。如果最终开发出能为每个符合条件的患者实现最佳干细胞动员的技术，那么外周干细胞采集或许可以在1至2天内完成。这些细胞可用于将与骨髓毒性疗法相关的造血毒性降至最低或减轻。或许这项技术最终将成为化疗给药的常规辅助手段。
