Preface

The last 10 years have again seen a dramatic change and expansion in the discipline of clinical bone marrow and blood stem cell transplantation. New data have become available to support the decision for or against transplantation. The future has already started. Basic science has made progress: New genes and microRNAs have been characterized as risk factors in the outcomes of hematologic malignancies. The involvement of natural killer cells in the graft-versus-tumor reactions has been recognized. New cell populations like dendritic cells and mesenchymal stem cells have been characterized. Clinical science has made progress. New indications for transplants have been developed and evaluated. Examples are renal cell cancer, autoimmune disorders, and amyloidosis. New stem cell sources (e.g., from cord blood) were implemented. Owing to sophisticated typing methods, unrelated transplants have become safer. Owing to increased donor numbers, matched unrelated transplants can now be offered to more than 70% of patients who do not have a family match. Old indications (breast cancer) have almost become obsolete or are being reevaluated (chronic myelogenous leukemia) because of advances in the nontransplant arena. In the first edition of this book, transplant for multiple myeloma was put into context against “conventional” treatments. Now, autologous transplant has become the standard of care for multiple myeloma, which has to compete and will join forces with antiangiogenic agents or proteasome inhibitors. New treatment protocols for older patients or who have significant comorbidities were introduced (reduced-intensity conditioning).