BONE-MARROW TRANSPLANTATION IMMUNOLOGICAL ASPECTS

Allogeneic bone marrow transplantation is concerned by immunology by at least two aspects : the first one is the acceptance of the graft by the host and reciprocally and the second one is that it constitutes an unique human model of immune reconstitution. In this review of the immunological aspects, we deal with the selection of the bone marrow donor (related or not) especially on the base of HLA compatibility and the graft - versus - host disease (GVH) with the clinical manifestations, the usual treatments, the supposed cellular mecanisms and the risk factors of developing such complications. The graft versus leukemia effect (GVL) which may be linked to the GVH disease and the mecanisms of rejection and take of the graft are also reviewed as well as the immune reconstitution following the immune deficiency due to the conditioning treatment and the occurence of a GVH disease.