Bone marrow transplantation is a rapidly evolving field that is likely to become more important in cancer treatment. The advances over the past 20 years have been remarkable.
The first attempt at allogeneic bone marrow transplantation was reported in the 1930s. It didn't work because the scientific advances that led to HLA typing had not yet been made. Autologous bone marrow transplantation was first tested in the 1950s. Once again, the attempt failed, this time because the techniques for cryopreservation of bone marrow cells had not been perfected.
The development of HLA typing in the 1960s made allogeneic transplantation a reasonable possibility, and the first successful transplants were performed at the end of that decade. Through the 1970s, allogeneic bone marrow transplantation gradually became an accepted form of therapy. The successful cryopreservation of bone marrow cells was perfected in the late 1970s, making autologous bone marrow transplantation a widely available therapy in the 1980s.
Now the future for the use of bone marrow transplantation in cancer treatment is optimistic. It is likely to be used for some time to treat leukemia and lymphoma. It also appears that more patients with carcinomas or sarcomas—solid tumors—will be identified who can benefit from, and possibly be cured by, the procedure. The increased use of hematopoietic growth factors to accelerate marrow regrowth after transplantation will likely make the technique safer and more widely available.
Also very exciting is that the ability to use peripheral blood stem cells has increased the number of patients who might benefit from autologous transplants, while the National Marrow Donor Program for identifying unrelated donors has greatly increased the number of patients who might benefit from allogeneic transplants.
