Blood cell-derived transplants at 40

February, 2026 is the 40th anniversary of the 1st publication of rapid recovery of bone marrow function after high-dose chemotherapy and infusion of an autologous blood- rather than a bone-marrow-derived graft. The recipient, a man with advanced Burkitt lymphoma, is in remission and alive. In the next 40 years transplants of blood-derived progenitor cells have become the most common graft for auto- and allotransplants. The rapid hematopoietic recovery after blood cell-derived grafts is associated with fewer short-term complications and better outcomes in many settings compared with bone marrow-derived grafts but may be associated with more graft-versus-host disease (GvHD) after allotransplants. Using blood-derived grafts also reduced costs, enabled the development of cell-based immune therapy and in vitro manipulation of blood-derived cells for gene and chimeric antigen receptor (CAR)-T-cell therapies.