Cell selection in marrow and stem cell transplantation

High-dose therapy with subsequent allogeneic or autologous transplantation of haemopoietic progenitor cells has proved to be an important therapy for patients with haematological malignancies, certain non-haematological cance rs and several nonmalignant disorders such as severe aplastic anaemia. Allo geneic and autologous transplantation are associated with specific complica tions. One major problem after allotransplantation is the graft versus host disease with jaundice, diarrhoea and erythema. The major problem of autolo gous stem cell transplantation is a potential reinfusion of contaminating t umor cells. Allogeneic transplantation has been refined, and an approach to modulate graft versus host disease is a partial or complete lymphocyte dep letion. Especially in the allogeneic setting, the field of cell therapy for modulation of graft versus host disease and treatment of transplant-relate d complications is expanding. For autologous transplantation different tech niques to purge autografts from malignant contaminants have been developed. These cell selection techniques consist of immunological, biological, cult ural, chemotherapeutical and physical techniques. This article reviews tech niques currently used for graft engineering in bone marrow and blood stem c ell transplantation.