Bone marrow transplantation (BMT) to treat hematologic malignancy has developed over several decades of research on both animal and human subjects as an effective treatment for varieties of malignant and nonmalignant disease. Initial research into the lethal effects of radiation led to the discovery that, when the spleen was protected, mice treated with high doses of total body irradiation (TBI) were able to repopulate the marrow and survive. Subsequent studies showed that infusion of bone marrow from a different strain of mouse could also successfully rescue lethally irradiated mice, and that the cytogenetic characteristics of the marrow in recipients were consistent with those of the donor rather than of the recipient's original marrow. Strain-specific tolerance to allogeneic skin grafting was also demonstrated in the recipient mice.

Transplantation in patients with leukemia followed but was initially limited to only those patients with no other treatment options. The first successful bone marrow transplantations were performed on patients who had identical twin donors. Slowly, as additional information concerning the HLA system, the origins of graft-versus-host disease (GvHD), and later its treatment became available, transplantation from HLA-identical sibling donors became feasible. Better understanding of the supportive care of transplant recipients increased the safety of the procedure and made BMT a treatment option available to an ever-growing number of patients.

Today, more than 20,000 patients have survived 5 or more years after allogeneic transplantation, and the number of allogeneic transplantations performed each year continues to increase rapidly. The indications for allogeneic bone marrow transplantation (alloBMT) are beginning to change as research continues on transplantation to treat genetic diseases. This article focuses on the use of alloBMT for the treatment of hematologic malignancies, including acute myelogenous leukemia (AML), chronic myelogenous leukemia (CML), acute lymphoblastic leukemia (ALL), myelodysplastic syndrome (MDS), and chronic lymphocytic leukemia (CLL).