Dan Med Bull
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Allogeneic hematopoietic cell transplantation (HCT) represents a potentially curative treatment modality in a range of hematologic malignancies. High-dose myeloablative radio-chemotherapy has conventionally been used as part of the preparative regimen before HCT for two reasons: it has a profound immunosuppressive effect on the host, limiting the ability to reject the graft and it has substantial anti-tumor efficacy. Graft rejection is an example of alloreactivity as alloreactivity denotes the immunologic reactions that occur when tissues are transplanted between two individuals within the same species. ⋯ However, many issues such as whom to transplant and when the transplant should be performed remain to be clarified. Large prospective studies, involving collaboration between centers, are needed to define the role of HCT with nonmyeloablative conditioning along with other treatment modalities. In addition, it is important to continue to elucidate the immunologic mechanisms that are responsible for GVHD and the GVT effect.