Transplantation of autologous peripheral blood stem cells mobilized using GM-CSF for acute leukemia with myelofibrosis

A patient with acute mixed lineage leukemia had marked marrow fibrosis at presentation. The fibrosis persisted despite achievement of complete remission. Because the marrow was inaspirable, granulocyte-monocyte colony-stimulating factor (GM-CSF) was used to mobilize stem cells into the peripheral blood which were used for autologous transplantation. Myeloid engraftment was rapid. The extent of the fibrosis decreased after transplantation. GM-CSF-mobilized peripheral blood stem cells may be used for autologous transplantation in patients with fibrotic marrows who are not candidates for allografting.