Abstract
To improve the therapeutic results of children with high-risk malignancies, high-dose therapy and autografts with peripheral blood hematopoietic stem cell (PBSCT) has been developed. PBSC collection is easily applicable without the risk of anesthesia or invasive multiple marrow aspirations. Rapid hematopoietic recovery and fewer complications related to PBSCT have eliminated the need of strict aseptic patient care protocol and made cure-oriented high-dose therapy far safer and easier to apply. Introduction of G-CSF-combined mobilization of PBSC further facilitated the popularity of PBSCT. Our preliminary data with children with early relapsing acute lymphoblastic leukemia suggest that application of PBSCT results in increase in the salvage rate of patients, while avoiding toxicities of allogeneic bone marrow transplantation. Development of an effective procedure for allogeneic transplantation with PBSC or ex vivo expansion of cells to eliminate the pancytopenic period following high-dose therapy has been underway. Its role outside of cancer therapy will continue to evolve and the procedure may become critical in the development of a realistic protocol for gene therapy.
