[Substitution of blood components]

Cell substitution in the form of "tailored haemotherapy " should be an essential part of medical oncology at the present time. In the conventional therapy of solid tumors patients do not enter into prolonged phases of severe haemopoietic insufficiency. Accordingly platelet and granulocyte transfusions will be exceptional. It is mainly the red cell transfusion which plays the most important role. The possible complication of cell substitution should always be kept in mind. Here the risk of alloimmunisation which makes a continuation of transfusion therapy or a subsequent bone marrow transplantation problematic, is just one of the examples. Modern cell separation techniques allow the production of highly concentrated cell preparations aiming at the reduction of the frequency of transfusions and minimizing the risk of sensitisation. If rich concentrated preparations have to be given to immunodeficient patients an irradiation should proceed their transfusion, otherwise the immunocompetent lymphocytes contained in the preparations could induce graft versus host reactions. Allogenic bone marrow transplantation is more becoming the treatment of choice for severe combined immunodeficiency, severe aplastic anemia, acute myeloid leukemia, and chronic myeloid leukemia. At the present time the place of allogeneic or autologous bone marrow transplantation as a treatment of lymphomas and solid tumors is still unsettled.