[Bone marrow transplantation--new developments in the last decade].

Area of Science:

• Hematology
• Oncology
• Immunology

Context:

• Significant advancements in bone marrow transplantation (BMT) over the past decade have enhanced its safety and accessibility.
• Expansion of international unrelated donor registries and fetal cord blood stem cell banks increases donor availability.
• Improved technologies facilitate stem cell transplantation from partially matched family members, broadening patient eligibility.

Purpose:

• To survey recent developments in BMT, including donor availability and technological improvements.
• To review evidence-based clinical indications for BMT in specific malignancies.
• To discuss the role and timing of BMT in light of emerging alternative treatments and inherent late side effects.

Summary:

• BMT's role in cancer treatment has evolved, recognizing the potential for donor immune cells to target malignant cells.
• Non-myeloablative conditioning regimens reduce the intensity of myelotoxic drugs, increasing procedure safety and expanding eligibility to older patients and those lacking fully matched donors.
• The article critically evaluates BMT's indications and timing, especially in Israel, where BMT rates are high, considering late side effects.

Impact:

• Increased patient eligibility for BMT, including older individuals and those without matched family donors.
• Enhanced safety profile of BMT through less intensive conditioning regimens.
• Provides a critical evaluation of BMT's role and timing amidst evolving cancer treatment landscapes.