Several methods to mobilize PBSC from an extra vascular location into circulation have been described. Myelosuppressive chemotherapy was the first method described for stem cell mobilization.14 During the recovery phase after myelosuppressive chemotherapy, there was a 14- to 100-fold increase in peripheral blood CFU-GM above the baseline. The extent of this increase is proportional to the severity and duration of the cytopenia. High-dose cyclophosphamide (CY) is the most commonly used regimen since it is active against most tumors. However, there are several disadvantages to chemotherapy mobilization, including the length of time required, toxicity, neutropenic fever and/or sepsis, bleeding diathesis, and the unpredictable timing of apheresis. In addition, little or no increase in peripheral blood CFU-GM was observed in some patients who had received extensive prior therapy and patients with marrow involvement with tumor.15 With the introduction of hematopoietic growth factors, it is no longer acceptable to use myelosuppressive chemotherapy alone for stem cell mobilization.
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