Future prospects

Mobilized peripheral blood cells are emerging to be the main haematopoietic progenitor cell sources in both autologous and allogeneic transplantation. The superior engraftment kinetics make high-dose therapy (HDT) safer and more cost-effective. Advances in mobilization protocols will enable an adequate, efficacious and predictable progenitor cell yield for most patients, and may even permit differential mobilization of normal and tumour cells. Peripheral blood stem cell transplantation is going to make an impact on tumour control by allowing dose escalation through multiple HDT and rescues, promoting various purging manoeuvres and facilitating immunomodulatory approaches to enhance graft-versus-tumour responses. Technological advances in ex vivo expansion and manipulation of haematopoietic progenitor cell grafts will add to our armamentarium of new therapeutic approaches and broaden our dimensions in the use of peripheral blood stem cell transplantation.