[Allogeneic bone marrow transplantation in malignant blood diseases]

Allogeneic bone marrow transplantation has an established role in the treatment of malignant blood diseases. For some disorders it is at the moment the only curative treatment. As the complication risks of this treatment increase with age, the upper age limit for allogeneic transplantation is usually 50 to 60 years. The main indications are acute leukaemias, chronic myeloid leukaemia and myelodysplastic syndromes. Selected patients with chronic lymphatic leukaemia, multiple myeloma and lymphoma are also treated with allogeneic transplantation. The most common intensive conditioning regimen preceding the transplantation consists of total body irradiation and cyclophosphamide. The source of haematopoietic stem cells has routinely been bone marrow, but the number of transplantations with stem cells harvested from blood is rapidly increasing. The proportion of transplantations from unrelated donors is growing. Histocompatibility testing is becoming more precise, which is likely to improve the results of unrelated donor transplantations to the level achieved with sibling donor transplantations.