Overview of Hematopoietic Cell Transplantation for the Treatment of Hematologic Malignancies

Allogeneic hematopoietic cell transplantation offers the best chance for cure in many hematologic malignancies. Key decisions include patient selection, donor and graft source, conditioning regimen, and graft-versus-host disease (GVHD) prophylaxis. Transplant is risky; only one-third survive long term. Complications include relapse, GVHD, infection, and end-organ dysfunction. Expanding indications for transplantation, advancing upper age limits, and improvements in patient care have resulted in increasing numbers of transplant survivors. These patients may suffer substantial long-term health consequences and require intensive follow-up. Future directions include graft engineering and cellular therapy, optimizing donor selection, sensitive disease assessments and/or maintenance therapies, and improvements in care.