Conclusions

Currently, mobilized PBSCs are the preferable and major source of stem cells harvested for autologous, and possibly, allogeneic transplantation because of the higher cell yield, faster hematopoietic and immune reconstitution, and decreased procedural risks compared with harvested BM cells. Measurement of PB CD34+ cells before collection is necessary for efficient and cost-effective stem cell collection. PBSC collection should be performed early in the course of disease to avoid chemotherapy-induced stem cell damage and to reduce the risk of therapy-induced myelodysplasia. Different mobilization strategies are needed for patients who are at high risk for poor mobilization. Over the last decade, significant progress has been made in understanding the mechanisms of PBSC mobilization and stem cell homing. This has led to the development of new agents that are being tested in clinical trials, which will eventually lead to development of improved mobilization protocols especially for poor mobilizers.

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