Allogeneic stem cell transplantation for the treatment of hematologic malignancies: current indications and challenges.

Allogeneic stem cell transplantation is a potentially curative treatment for hematologic malignancies. Research efforts are expanding the acceptable donor pool to increase patient access to this form of therapy. Potential sources besides HLA matched siblings include partially mismatched family members, unrelated volunteers, and cord blood stem cells. Although allogeneic hematopoietic stem cell (ASC) transplantation may cure hematologic malignancies, relapse remains a problem. To prevent relapse after transplant, research efforts are focused on optimizing the delivery of systemic chemoradiotherapy, including strategies for targeting therapy to sites of disease, and augmenting the antileukemic effect of the allogeneic graft. It is a challenge to maintain clinical research in the current environment of limited resources, so new paradigms for support of this work may need consideration.