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Bone Marrow Transplantation

  • Alberto M. Marmont
Part of the European School of Oncology book series (ESO MONOGRAPHS)

Abstract

The ablation of pathological bone marrow by means of myelosuppressive “conditioning” regimens, with the purpose of eradicating disease-perpetuating clonogenic cells, be they leukaemic, congenitally altered or merely irreversibly insufficient, must be followed by the administration of an allogeneic or syngeneic bone marrow suspension containing a number of haemopoietic stem cells (HSC) adequate to ensure engraftment and subsequent reconstitution. Autologous bone marrow transplantation (AutoBMT) is closely similar to the allogeneic/syngeneic procedure (AlloBMT) in the treatment of leukaemia and other malignancies, while being obviously out of the question for the treatment of marrow aplasia, inborn errors and others, in which HSCs must come from a healthy donor. Immune problems (donor availability, graft-versus-host disease, GvHD) and scarcely elucidated but undisputably favourable effects (graft-versus-leukaemia, GvL) dominate the allogeneic setting, while in the autologous one elimination of the residual leukaemic clonogenic cells in the remission marrow is a major problem. However, the utilisation of peripheral HSGs is gradually becoming a procedure of major importance, especially when they are collected in the overshoot waves associated with haemopoietic reconstitution following myelosuppressive chemotherapy [1–5], where contamination with residual leukaemic cells is even less than in the marrow [6]. The successful utilisation of non-clonal HSCs, grown in and harvested from long-term cultures of marrows of patients with acute myeloid leukaemia (AML), has also been reported [7].

Keywords

Acute Lymphoblastic Leukemia Human Leukocyte Antigen Bone Marrow Transplantation Acute Myeloid Leukaemia Acute Lymphoblastic Leukaemia 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer-Verlag Berlin Heidelberg 1990

Authors and Affiliations

  • Alberto M. Marmont
    • 1
    • 2
  1. 1.Bone Marrow Transplantation Centre, Genoa and Istituto Nazionale per la Ricerca sul Cancro (IST)Ospedale San MartinoGenoaItaly
  2. 2.Istituto Nazionale per la Ricerca sul Cancro (IST)GenoaItaly

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