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Foreword (from first edition)

by Professor John Goldman (1938–2013)

Though sadly, there has been little progress in recent years in some areas of medicine, the clinical use of hematopoietic stem cell transplantation is not one of them. If 50 years ago, one had suggested to an experienced hematologist that one could collect nucleated cells from the marrow or indeed from the blood of normal persons and infuse them in relatively small numbers into a suitably “prepared” patient with leukemia or another hematologic or immunologic disorder and thereby cure the disease, the suggestion would have been greeted with incredulity. In reality, the pioneering preclinical work of many laboratory scientists, the increased understanding of histocompatibility antigen, and the dedicated commitment of clinicians such as Georges Mathé, Robert Good, and Don Thomas laid the foundations for the first successful bone marrow transplant in the 1970s. It is difficult today to appreciate the scepticism or, indeed, formal opposition with which the initial work of these enthusiasts was met.

In the beginning of the 21st century, stem cell transplantation in some form or another is practised in 60 to 70 countries of the world and there is no aspiring hematologist who does not learn early that there are certain diseases for which allogenic or autologous stem cell transplantation offers a real chance of cure or, at worst, just useful palliation. This means that the number of persons surviving and, in many cases, cured of a serious and usually life‐threatening disease has increased enormously in recent years. This collection of papers, written by experts in the field of stem cell transplantation, could not have been contemplated by earlier researchers in the field for the simple reason that the number of patients who had survived long term would have been very few. Today, clinical data on transplant recipients are carefully collected and analysed by two very valuable organizations: on a global scale by the International Center for Blood and Bone Marrow Research and by the European Group for Blood and Marrow Transplantation, which focuses mainly on Europe. Data collated by these two agencies and the multiplicity of individual publications covering many aspects of health in patients alive at 5, 10 or more years after a transplant procedure show clearly that some long‐term survivors do still have specific problems associated with their original transplant procedures, but most of these are relatively minor and eminently treatable. The fact that there are so many “ex‐patients” alive today is a truly impressive testament to the progress that has been made in this field since the 1960s.

Professor John Goldman DM, FRCP, FRCPath, FMedSciHammersmith HospitalImperial College LondonCentre for HaematologyDu Cane RoadLondon, UK