Quality control of the graft in autologous transplantation

Hematopoietic stem cell transplantation (HSCT) has been rapidly expanding worldwide over the last twenty years for a broad spectrum of indications. In 2010, more than 50,000 first HSC transplants have been conducted of which 43% were allogeneic and 57% autologous. The majority of stem cell products are derived from bone marrow (BM), peripheral blood (PB) and cord blood (CB). Data from European Blood and Marrow Transplantation (EBMT) registry shows that the number of transplants has increased by 19% since 2005 (allogeneic 37% and autologous 9%) and continued to increase by about 1100 HSCT per year since 2000.Taking together all this data confirmed that further variables other than CD34+ cell number play a role in transplant outcome. These findings underlined the need of a more extensive quality assessment of autologous PBSCT, taking into account that transplant outcome is influenced not only by graft content but also by other important parameters such as time in hospital, supportive care as blood transfusion and antibiotic therapy and grade of toxicity and the shortly occurrence of relapse or death after transplant.