Prospects for the future of bone marrow transplantation from the experimental studies on cells and animals

Despite accumulated extensive clinical experience bone marrow transplantation (BMT) remains a largely experimental procedure with high risk and numerous limitations. Part of the progress has to come from improvements in clinical care, but still as in former years there is a need of implementation of results of experiments on cells and animals. In the area of better engineering of posttransplant haemopoietic and immune cell production, this include variable pretransplant modifications of composition of inoculated cells as well as utilization of new drugs and growth factors. In the area of BM donor selection this includes identification of minor histocompatibility antigens. In the area of applications except for being a replacement therapy of haematologic disorders BMT may be considered as an adjunct therapy for transplantation of various organs. Finally, combination of cellular engineering of BM inoculum with genetic modifications of cells may offer therapy for some patients.