The Blood and Marrow Transplantation Program at University of Iowa Hospitals and Clinics performed its first transplant in January 1980. The first transplants used matched sibling marrow donors. Two issues quickly became obvious:

• This form of therapy offered a revolutionary change in the approach and outcome for patients with devastating cancers
• Alternative sources of marrow stem cells would be necessary for many patients who could benefit from this therapy but who did not have a matched sibling

The program for autologous marrow stem cell donation (that is, donating to oneself) was established in 1982, initially for patients with lymphoma, a disease in which the bone marrow is not contaminated with tumor cells. Subsequently, patients with a variety of other cancers have benefited from this approach, including those with breast cancer. In 1981, the UI Bone and Marrow Transplant Program was one of the first programs to use an unrelated marrow donor for a transplant. The first Unrelated Marrow Donor Registry in the world was established at UI Hospitals and Clinics in 1984 and the first publication in the medical literature of a group of patients transplanted with unrelated donor marrow came from our center in 1985.

Research efforts in critical areas of blood and marrow stem cell transplantation continue to characterize our program. Holden Comprehensive Cancer Center, an National Cancer Institute-designated Comprehensive Cancer Center, continues to be fully committed to research that leads to improvements in the outcome of this therapy and to its wider application.

• We are involved in national studies, cooperative group studies and center-based, investigator-initiated studies:
• In the prevention and treatment of graft versus host disease
• In the prevention and treatment of recurrent cancer following a transplant
• More effective induction therapy for patients with lymphoma who are candidates for transplant therapy
• The use of transplant approaches in the treatment of solid tumor malignancies and immunological diseases.

We have an established track record for treating women with breast cancer using a more aggressive regimen than has been employed elsewhere. Research in supportive care has been deemed important and we continue to be involved in studies on antibiotic use, blood and marrow stem cell growth factor use and methods to improve on the safety of blood product transfusions.