[Autografts of bone marrow and current role of cytokines in hematology].

This paper reviews the present status of the transplantation of autologous stem cells and the recent development of cytokines. Since 1977, autologous bone marrow transplantation has considerably expanded its scope. In France, more than 1,300 autologous bone marrow transplantations (ABMT) are performed per year, in parallel to 560 allogeneic bone marrow transplantation (BMT). ABMT has become a routine procedure for the treatment of patients with acute leukemias (results very similar to those of BMT), lymphomas, myelomas, as well as some selected tumors (breast and testicular cancers). In parallel to the development of ABMT and BMT, more than 30 cytokines have been individualized. Many of them are presently tested in clinical trials and some (GMCSF, GCSF, Erythropoietin, Interferons) are marketed. One of the most recent development which combines the two fields includes the selection and purification of immature normal stem cells recognized by the CD 34 monoclonal antibodies, their expansion in vitro by liquid culture in presence of multiple cytokines and gene transfer before autografting. These fields are reviewed.