Tumor contamination and purging

The major advantages of autologous hematopoietic stem cells are that almost every patient can serve as his/her own donor and there is no graft rejection or GVHD, although attempts have been made to induce autologous GVHD and GVL, as discussed next. Thus, autologous HSCT is also associated with a relatively low treatment-related mortality rate, which varies with disease, disease state, and age. The major disadvantages are that the autologous stem cell graft may be contaminated with tumor cells and, similar to syn-geneic HSCT, is not associated with a GVL effect. The contribution of autograft contamination by tumor cells to relapse has varying clinical significance.66-68 Attempts have been made to remove or "purge" tumor cells from the autograft using various methods prior to autologous HSCT.69-71 However, there is only retrospective and anecdotal evidence that autograft purging results in an improved clinical outcome.4872

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