[Current perspectives in bone marrow transplantation]

Peripheral blood and umbilical cord blood are promising sources of hemopoietic stem cells for autologous as well as allogeneic transplantation. The nature of the progenitors responsible for early marrow reconstitution after transplantation on one hand and for permanent reconstitution on the other hand is getting more precise. Features of the cells responsible for GVHD and of those responsible for GVL effect (graft versus leukemia effect) will soon allow a distinct monitoring of these two activities. Molecular biology will soon permit genetic labelling of the graft and thereby bring more precision for its follow-up and modulation in vivo in the post-graft period. Correction of an autologous transplant by introduction of the adequate gene in the hematopoietic stem cells in case of genetic anomaly at this level, should in the future, as suggested by animal studies, allow permanent correction of genetic disorders in patients autografted according to such a procedure. Finally, introduction of procedure like antisense nucleotides against DNA regions responsible for the malignant proliferation of tumoral cell, could extend the therapeutic possibilities of autograft.