[Supportive care in bone marrow failure. Technical, immunological and clinical advances].

Supportive care with blood component transfusions has greatly improved prognosis in patients with bone marrow failure. This progress has made possible by newly developed techniques for separation of blood cells and by a better understanding of the antigenicity of human blood cells and of immunologic reactions following their transfusion. Transfusion of white cell and platelet-poor red cell preparations prevent alloimmunization to leukocyte and platelet-bound alloantigens, or non-hemolytic transfusion reactions in already alloimmunized patients. Alloimmunization can be circumvened and effective long-term platelet support to thrombocytopenic patients can be provided by matching donor and recipient for HL-A antigens. The place of granulocyte transfusion in clinical therapy has yet to be defined, although their usefulness in infected granulocytopenic patients is suggested by the few studies reported so far.