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 of advance occurred in the field of transplantation immunology. Since that time, bone marrow transplantation techniques have acquired considerable sophistication. Currently, transplantation is used for a variety of disorders including the leukemias, severe combined immunodeficiency states, osteoporosis, and various inherited diseases. In addition, it is also being investigated as a possible therapeutic tool against certain solid tumors.
The procedure involved in bone marrow transplantation is relatively simple (2:519). 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) (2:519).
Initially, some of the first bone marrow transplants were performed on victims of radiation exposure (2:519). Bone marrow proliferates constantly and thus tends to be extremely sensitive to radiation. In the wake of the Chernobyl disaster, such treatment strategies have been re examined. It has been found though that thermal injury and damage to other organ systems contribute to an extremely poor prognosis in irradiated patients (2:519).
With the technological breakthroughs of the 1960s, bone marrow transplantation techniques were subsequently applied to the treatment of acute leukemia. This eventually led to the establishment of many bone marrow transplantation centers (2:519).
The acute leukemias are neoplastic diseases of the bone marrow stem cells.
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