Ex vivo manipulation of hematopoietic stem and progenitor cells

Ex vivo manipulations of hematopoietic stem and progenitor cells are increasingly used in the context of autologous and allogeneic stem-cell transplantation. These manipulations include the positive selection of CD34+ cells for tumor-cell reduction and/or T-cell depletion, the ex vivo expansion of hematopoietic progenitor and stem cells under appropriate cytokine- stimulated culture conditions, and the ex vivo generation of myeloid or megakaryocytic postprogenitor cells and immune effector cells. This article summarizes both the preclinical data on the ex vivo expansion of hematopoietic progenitor and stem cells from purified CD34+ cells and the initial clinical studies with ex vivo-expanded stem and progenitor cells for hematopoietic support after high-dose chemotherapy. Copyright (C) 2000 by W.B. Saunders Company.