From blood to biotherapies: A brief historical perspective

Transfusion medicine represents the earliest and most enduring example of biotherapy, originating with Blundell's first successful human blood transfusion in 1818 and transformed into a precise, reliable treatment through Landsteiner's discovery of the ABO blood group system in 1901. These foundational advances established the therapeutic use of living cells and created the systems of donor stewardship, product safety, and laboratory precision that continue to define the field today. This commentary outlines how transfusion medicine built the operational, scientific, and regulatory frameworks that underpin the modern era of cellular and gene therapies (CGTs). The principles essential to transfusion, that is, safe donor management, standardized collection and processing, compatibility and infectious agents testing, GMP/GTP manufacturing, and robust quality systems, form the backbone of hematopoietic cell transplantation, engineered immunotherapies such as CAR-T cells, and emerging regenerative and gene-editing technologies. We herein highlight the central role of transfusion professionals in apheresis, cell processing, logistics, and quality assurance. A global perspective underscores that access to high-quality transfusion services is a prerequisite for equitable access to CGTs and that sustainable investment in transfusion infrastructure remains essential, particularly in low- and middle-income countries. Transfusion medicine is not a historical precursor to cellular therapy; it is an active leader in shaping the future of biotherapies. Its century-long commitment to safety, quality, and innovation provides the foundation on which advanced cellular and gene-based therapies continue to evolve. By carrying forward these principles, transfusion medicine ensures that the promise of regenerative medicine and immunotherapy is realized safely, effectively, and equitably worldwide.