AUTOLOGOUS BONE-MARROW TRANSPLANTATION - THE ROLE OF CYTOKINES - PRESENT STATUS

This paper reviews the present status of the transplantation of autolo gous stem cells and the recent development of cytokines. Since 1977, a utologous bone marrow transplantation has considerably expanded its sc ope. In France, more than 1,300 autologous bone marrow transplantation s (ABMT) are performed per year, in parallel to 560 allogeneic bone ma rrow transplantation (BMT). ABMT has become a routine procedure for th e treatment of patients with acute leukemias (results very similar to those of BMT), lymphomas, myelomas, as well as some selected tumors (b reast and testicular cancers). In parallel to the development of ABMT and BMT, more than 30 cytokines have been individualized. Many of them are presently tested in clinical trials and some (GMCSF, GCSF, Erythr opoietin, Interferons) are marketted. One of the most recent developme nt which combines the two fields includes the selection and purificati on of immature normal stem cells recognized by the CD 34 monoclonal an tibodies, their expansion in vitro by liquid culture in presence of mu ltiple cytokines and gene transfert before autografting. These fields are reviewed.