[What is a non-myeloablative transplantation of hematopoietic cells?]

Transplantation of haematopoietic cells, dominantly peripheral stem cells, after a non-myeloablative regime is nowadays a very intensely investigated method. Its principle involves that the pretransplantation regime accentuates the immunosuppressive component to prevent transplant rejection but reduces the antitumourous component (chemotherapy or irradiation). It was demonstrated that the reaction of allogene transplanted lymphocytes against the residual tumour is the dominant anti-tumourous component of the whole allogene transplantation. Thus the acute toxicity of the whole procedure is reduced. The initial experience with this method is so far very promising. This is apparent from a review of the literature and 21 transplantations made by the authors. It appears also that this method will probably not be very suitable for patients with very advanced tumourous disease. There the antitumourous effects will not be sufficient. At present there are many pretransplantation regimes. This may be an advantage for seeking an optimal regime but it may also obscure the whole problem. Quite new horizons are offered by transplantation of allogenic T lymphocytes of HLA identical donors in the treatment of solid tumours. The first data were published for renal adenocarcinoma and are very promising.