The South African Bone Marrow Registry (SABMR) and allogeneic bone marrow transplantation

In 1939 Osgood et al. reported infusing bone marrow into patients with severe aplastic anaemia without any clinical benefit. Rekers and Coulter attempted to reconstitute marrow function in irradiated dogs by marrow infusions. Both failed because of insufficient irradiation to produce immunosuppression necessary for engraftment. In 1957 Donnall Thomas and co-workers showed that marrow can be collected, stored in significant quantities and safely administered. Marrow transplants remained unsuccessful, however, although patients with refractory leukaemia given supralethal irradiation recovered after marrow infusion from identical twins. Allogeneic marrow transplants usually resulted in failed engraftment, or engraftment followed by lethal graft-versus-host disease (GVHD). Further discoveries were the HLA complex and transplantation antigens, and that successful allogeneic engrafting depends upon donor/recipient histocompatibility