Bone marrow transplant is a fast-changing field, with new advances occurring regularly. At present, two new types of bone marrow transplants are being studied in clinical trials and producing significant results. They are:

• Mini-transplant. Also called a non-myeloablative or reduced-intensity transplant, this is a type of allogeneic transplant that uses lower, less toxic doses of chemotherapy or radiation to prepare patients for bone marrow transplants. These lower doses do not completely destroy the patient’s bone marrow but still reduce levels of cancer cells and suppress the immune system to prevent rejection of the transplant. These treatments are being used in older patients and those with solid tumors. The number of transplants performed in patients older than 50 years has increased steadily since 1984.
  
  Unlike a traditional bone marrow transplant, cells from both the donor and the patient coexist in the body for a while after a mini–transplant. However, as the donor cells begin the process of engraftment, they may trigger the graft-versus-tumor (GVT) effect and begin destryoing cancer cells that remain after chemotherapy or radiation.
  
  Mini-transplants are being tested for use in treating:
• • Leukemia
  • Lymphoma
  • Multiple myeloma
  • Other cancers of the blood
    
    
• Tandem transplant. A type of autologous transplant that involves two sequential courses of high-dose chemotherapy with a stem cell transplant. In most cases, two treatment courses are given several weeks to several months apart.
  
  Researchers are hopeful this method will help prevent cancers from recurring later. It is being tested for use in patients with multiple myeloma.

Research also has focused on optimal timing for transplants in cancer patients, better management of transplant complications and improved methods for matching donors and patients. Medications, including vaccines, continue to be studied to prevent infections and graft-versus-host disease, which can be life-threatening. Researchers are also examining factors, such as proteins or specific stem cells, that may help predict the success of a transplant. Other areas of research are investigating other uses for bone marrow transplants, such as following an organ transplant to reduce the risk of rejection. There are numerous clinical trials being conducted in the areas of bone marrow, stem cell and cord blood transplants. A patient’s physicians can best determine if an individual is a candidate for a clinical trial.