Peripheral stem cell transplantation

Granulocyte colony stimulating factor (GCSF) are naturally occurring glycoproteins that stimulate white blood cell proliferation. Filgrastim is a synthetic form of GCSF produced in E.coli. PBSC donors are given a course of GCSF prior to PBSC collection. The increase in white blood cell proliferation as a result of the Filgrastim ensures a better results from the donation. The course is usually given over a 4-day period prior to PBSC collection. The most common side effects of Filgrastim are bone, joint, back, arm, leg, mouth, throat, and muscle pain. Additionally, headache, nausea, vomiting, dizziness, fatigue, rash, loss of appetite, and difficulty falling or staying asleep are common. ==Complications==

Since allogeneic PBSCT involves transformation of blood between different individuals, this naturally carries more complications than autologous PBSCT. For example, calculations must be made to ensure consistency in the amount of total blood volume between the donor and recipient. If the total blood volume of the donor is less than that of the recipient (such as when a child is donating to an adult), multiple PBSCT sessions may be required for adequate collection. Performing such a collection in a single setting could result in risks such as hypovolemia, which could lead to cardiac arrest and death. Health care providers must exercise careful precaution when considering donor-recipient matching in allogeneic PBSCT. ==History==

An early example of a successful peripheral stem cell transplant was carried out in the wake of the 1999 Tokaimura nuclear accident. Hisashi Ouchi, who received the highest dose of radiation was treated with PBSCT in an attempt to restore his destroyed immune system. Cells from the patient's sister's bone marrow were administered, and in the following weeks successfully began dividing and differentiating into white blood cells. However, several weeks later, the cells were found to have been mutated by the radiation still present within the patient's body, and were observed carrying out autoimmune responses. Later studies on the incident and subsequent use of PBSCT found that the transplant had also induced neoendothelialization of the aortic endothelium. ==References==