Bone marrow transplantation as treatment of hematologic disease.

The clinical achievements in bone marrow transplantation are the culmination of more than 20 years of study of the principles of transplant biology, tissue typing, supportive care, and pregrafting and postgrafting regimens. Bone marrow transplantation, which involves replacing defective or abnormal marrow with normal donor marrow, is explored. The marrow transplant preparative regimen must suppress the recipient's response and destroy any malignant cells. Indications for bone marrow transplantation are outlined, and studies of the use of transplantation in the treatment of various disorders are discussed. Research continues to focus on the problems associated with marrow transplantation, which include immune deficiency, opportunistic infections, graft failure, the recurrence of the original disease, and acute and chronic graft-versus-host disease (GVHD).