Recent experience demonstrates that peripheral blood stem cells collected from normal donors by apheresis, the same procedure routinely used to collect platelets, provides an adequate number of hematopoietic progenitor cells for full hematopoietic recovery in an allogeneic recipient without the disadvantages of a marrow harvest under general anesthesia for the donor.
Bone marrow is obtained from multiple aspirations of the donor's iliac crests.
The marrow is then filtered and readied for intravenous infusion into the recipient. Concerns have been raised regarding the use of a hematopoietic growth factor in a normal individual. Studies in children with congenital neutropenia treated with filgrastim have demonstrated no excess in long-term adverse events, suggesting that there would be little if any late risk for normal donors. However, to address this concern, a registry is being established to follow blood stem cell donors long-term and to compare their experiences to those of marrow donors. In addition, preclinical studies are underway to develop new agents for mobilization with even fewer potential side effects.