Peripheral blood stem cells or bone marrow as the graft source for allogeneic hematopoietic cell transplantation?

Bone marrow (BM), granulocyte-colony stimulating factor mobilized peripheral blood stem cells (PBSC) and cord blood are the 3 sources of stem cells for allogeneic hematopoietic cell transplantation (HCT) that have been used to cure hematological malignancies and other disorders. Bone marrow obtained by repeated aspiration of the posterior iliac crests while the donor is under general or local anesthesia was the first source of hematopoietic stem cells. Introduction of PBSC as a source of stem cells resulted in important changes in transplant practices and outcomes. PBSC harvesting is more convenient for the donors with the advantage of avoiding anesthesia and hospitalization. There are differences in the composition of the graft sources that are reflected in different clinical outcomes both favorable and unfavorable. While the field of cord blood transplant is still in its infancy, there has been over the years many studies aimed at determining whether BM or PBSC grafts are superior. This review article summarizes our current knowledge on clinical outcomes between allogeneic transplants performed with peripheral blood stem cells (PBSC) and bone marrow (BM).