Progress in clinical application of use of progenitor cells expanded with hematopoietic growth factors

The ability to isolate and expand the cells capable of reconstituting hemat opoiesis and immunity holds great promise to improve the outcomes of patien ts treated with autologous and allogeneic transplantation. The morbidity ca used by prolonged neutropenia resulting from myeloablative therapy in the t ransplant setting leaves patients at risk to develop serious infections. Pe ripheral blood progenitor cells (PBPC) have supplanted bone marrow in autol ogous and allogeneic transplantation as a source of hematopoietic reconstit ution mainly because of a reduction in the duration of neutropenia. Regardl ess, neutrophil recovery times continue to range between 7 to 10 days and p latelet recovery times range between 12 to 24 days, after infusion of PBPC. Thus, ex vivo culture of PBPC has been evaluated for the purpose of provid ing a larger number of hematopoietic cells intended to accelerate the rate of recovery after myeloablative therapy. Moreover, expansion of alternative hematopoietic stem cell sources, including umbilical cord blood, has been tested in clinical trials. (C) 2001 Lippincott Williams & Wilkins, Inc.