Autologous peripheral blood stem cell transplantation: Predictors for haematopoietic reconstitution

Autologous peripheral blood stem cell transplantation is currently used in the treatment of various haematological and non-haematological cancers. Until recently, colony forming unit-granulocyte-macrophage (CFU-GM) assay and mononuclear cell (MNC) count were the indices commonly used to determine the quality of stem cell grafts and the haematopoietic reconstitutive capacity of transplanted stem cells. However, the discovery of CD34 as a stem cell marker has revolutionized the assessment of progenitor cells present in the peripheral blood stem cell graft. Many studies have included enumeration of CD34+ cells, MNCs and CFU-GM assay in stem cell grafts, and their correlation with engraftment has also been studied. However, there is no consensus regarding the optimum dose of each parameter that ensures haematopoietic recovery in all patients. We discuss the stem cell biology and review the literature on stem cell characteristics influencing successful haemopoietic reconstitution.