Peripheral Blood Stem Cells

Use of peripheral blood stem cells for autologous transplantation in acute myeloid leukemia patients allows faster engraftment and equivalent disease-free survival compared with bone marrow cells


We compared the feasibility and efficacy of autologous bone marrow (ABMT) and peripheral blood progenitor cell transplantation (PBSCT) performed after an identical induction/consolidation in adults with acute myeloid leukemia (AML). From January 1993 to June 1996 91 consecutive AML patients were enrolled in a program consisting of anthracycline-based induction and high-dose cytarabine consolidation (NOVIA). Until May 1994 ABMT was performed; from June 1994, if PBSC collection was adequate, PBSCT was performed. Out of 88 evaluable patients, 73 obtained a complete remission (CR) and 15 were resistant. Allogeneic bone marrow transplantation was performed in 16 patients. Forty-four (50%) were given autologous stem cell transplantation. ABMT was performed in 21 cases; twenty-nine patients were given G-CSF mobilization after NOVIA administration. An adequate number of PBSC was obtained in 23/29 (79%) cases, which were then re-infused. Median times to both neutrophil and platelet recovery from transplant were significantly shorter for the PBSC group (17 vs 36 days to 500 PMN/μl, P < 0.01; 20 vs 150 days to 20000 platelets/μl, P < 0.02; 37 vs 279 days to 50000 platelets/μl, P < 0.03), as were days of hospitalization after the reinfusion (18 vs 33, P < 0.03) and median days to transfusion independence. toxicity was not significant in either group. after a minimum follow-up for live patients of 24 months (longer than the mean time for relapse observed for the pbsc series – 14 months) the percentage of relapses was similar: 11 of 21 (52.4%) and 12 of 23 (52.1%) in the abmt and pbsc groups, respectively. our results indicate that autologous pbsc transplantation, performed after an intensive chemotherapy regimen, is not inferior to abmt in terms of disease-free survival and allows faster recovery times and reduced need for tranfusion support.

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Correspondence to G Visani.

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  • leukemia
  • myeloid
  • autologous
  • transplantation
  • stem cells

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