Early stage CLL patients frequently wonder if, before the disease progresses any further, they should have stem cells removed (harvested) and stored for possible autologous transplantation in the future.

For autologous transplantation to be successful, the patient's marrow must be relatively free of disease when it is harvested. By the time CLL is diagnosed, the percentage of leukemic cells in the marrow is generally higher than is acceptable for the harvest procedure. For this reason stem cells are usually not harvested until after treatment begins and a remission is achieved. Some treatment centers feel that the best time to perform the harvest is at the first or second treatment induced remission.

The decision on whether or not to harvest and store cells will depend on several factors including the overall treatment strategy that has been agreed to with the patient and the ability to achieve a treatment induced remission that eliminates sufficient disease to perform the harvest procedure.

Another consideration is that most institutions doing bone marrow transplants do not have sufficient storage facilities for long-term cell storage, and that overrides all other considerations at many cancer centers.