Current status of bone marrow purging prior to autografting for Hematological malignancies—future directions

While the debate remains largely open concerning the importance of purging in malignant hemopathies, we are currently witness to the extraordinary development of complex and expensive technologies associating several methods (immunochemoseparation procedure, drug cocktails …). Such techniques may be justified for acute leukemias at high risk of relapse when the residual disease is almost perceptible. Current objectives are oriented in several directions: development of techniques for detecting residual disease, development of immunophysical procedure (magnetic and floating immunobeads) and long-term human marrow cultures for selection of normal hematopoietic stem cells. Future progress in ABMT depends not only on the effective ex-vivo purging of marrow but also on development of more effective conditioning regimens (in vivo purging).