Bone Marrow, Peripheral Blood, or Umbilical Cord Blood: Does the Source of Allogeneic Hematopoietic Progenitor Cells Matter?

Rescue of the blood and immune cell production by transplantation of donor Hematopoietic Progenitor Cell (HPC) preparations has become an indispensable intervention for malignant and nonmalignant diseases. When a suitable donor is identified, currently two types of procedures may be employed to obtain progenitor cells. (i) Aspiration of 500 to maximal 1500ml Bone Marrow (BM) blood under general anesthesia from the iliac crest or (ii) harvest of progenitor cells by apheresis of mononuclear cells from peripheral blood (PB) after pretreatment with substances like Granulocyte-Colony Stimulating Factor (G-CSF) or a CXCR4 antagonist, which mobilize progenitor cells from bone marrow. The decision for one of the two procedures mainly depends on donor characteristics (e.g. condition of veins needed for access to apheresis or contraindications against anesthesia) and preferences of the donor and/or the transplant center. In recent years, as a third source of progenitor cells, blood from placenta and umbilical cord (cord blood, CB) has become available.