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Hematopoietic stem cell therapy is used widely for treatment of leukemia. The traditional source of hematopoietic stem cells for use in transplantation was bone marrow. The use of peripheral blood as a source of stem cells has now replaced bone marrow for most transplants. The difference between the two sources can be brought out in the table given below: Cellular Characteristics Bone Marrow Peripheral Blood Stem cell content Adequate Good Progenitor cell content Adequate Good T-Cell content Low High Bone Marrow harvesting under general anesthesia is limited by procedural risks (largely related to general or spinal anesthesia), which significantly increase with the donor's age and comorbid conditions. Peripheral Blood Stem Cell harvesting, on the other hand, can be performed safely on donors ranging from 1 year to the eighth decade. The principal limitation of the procedure is the need for venous access. Engraftment with peripheral blood is faster as compared to bone marrow, but again on the flip side, the risk of chronic graft vs host disease in patients has been found to be higher with peripheral blood stem cell transplantation. However, various studies have shown no difference between stem cell source and relapse rates or disease free survival. A difference in relapse rates, in favour of peripheral blood stem cells, does however emerge when patients are classified as per stage of leukemia. It is said that Peripheral blood stem cell transplantation is likely to overtake bone marrow, owing to the longer disease free survival rate in advanced stage cancer. Also added is the fact that it is easier to harvest specific cell types by immunogenic stimulation from peripheral blood than bone marrow make PBSC a more attractive option.. References: 1. Hematopoietic Stem Cell Transplantation, http://emedicine.medscape.com 2. Peripheral blood stem cell versus bone marrow allotransplantation: does the source of hematopoietic stem cells matter? Korbling and Anderson, Blood, 15 November 2001, Vol. 98, No. 10, pp. 2900-2908
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