One application of immunological methods to the treatment of human disease is bone marrow transplantation. During the 1960s, various technological advances led to the rapid development of this therapeutic modality. Perhaps the most important advance occurred in the field of transplantation immunology. Since that time, bone marrow transplantation techniques have acquired considerable sophistication. Currently, they are used for a variety of disorders including the leukemias, severe combined immunodeficiency states, osteoporosis, and various inherited diseases. In addition, bone marrow transplantation is also being considered for use against certain types of solid tumor.
The basic transplantation procedure is actually relatively simple (3:519). Multiple bone marrow aspirations are simply taken from a donor and transfused into a recipient. For transplant engrafting to occur, the donor and recipient must be matched with respect to their major histocompatibility antigens. Thus, donors should be an identical twin (syngeneic); another closely related individual such as a sibling (allogenic); or the patient himself (autologous) (3:519).
With the exception of the syngeneic transplants (and also patients with some form of immunologic deficiency), most recipients require some form of immunosuppressive medication (7:835). The particular pharmacologic agent used will depend on the patient's underlying medical condition. For example, with non malignant conditions such as aplastic anemia, cyclophosphamide may be employed. With malignant disorders, these conditioning treatments must not only suppress the recipient's immune system, but must also kill all or nearly all of the affected cells. Thus, leukemia patients will often receive total body irradiation prior to receiving a bone marrow graft.
The first bone marrow transplants were performed during the 1950s on mice (7:832). Researchers showed that marrow infusion...