[Autologous graft of hematopoietic stem cells. Current and perspective strategies]

Autologous transplantation of hematopoietic stem cells (HSC) is an alternative therapeutic for patients with malignant hemopathies (acute leukemia, lymphoma...) especially when no HLA-identical sibling donor is available. Hsc harvesting (marrow or peripheral blood) is performed during complete remission and is cryo-preserved in liquid nitrogen. The HSC graft, infused after treatment intensification, results in a rapidly occurring hematopoietic reconstitution. As the graft is potentially contaminated by residual malignant cells, an ex-vivo treatment by chemical or immunological treatment can contribute to a reduction and maybe even a disappearance of the malignant population. The encouraging results seen after presently autologous transplantation concerns unfortunately only selected groups of patients (acute myeloid leukemia in particular). Progress in biotechnologies (hematopoietic growth factors, monoclonal antibodies, interleukin-2) now allow us to consider new therapeutic strategies and should contribute to improved clinical results after autologous transplantation.