Normal bone marrow function depends on coexistence of normal hematopoietic stem cells and microenvironment mostly located in the medullary part of the bones. Stem cells cannot function properly in the absence of adequate mircoenvironment. Whereas in malignant and non-malignant hematologic diseases caused by deficiency or abnormal stem cells, stem cell transplantation is the treatment of choice that results in cure, in diseases such as MDS, myelofibrosis and other conditions associated with abnormal microenvironment, pancytopenia may occur despite presence of apparently normal hematopoietic cells with no recognizable cytogenetic abnormality.

We proved in experimental studies that the entire osteohematopoietic complex consisting of trabecular bone, hematopoietic microenvironment (of stromal origin) and hematopoietic tissue has been suffessfully transferred directly into ablated bone marrow cavity in a one-step transplantation procedure.

The goal of this study is to enhance hematopoiesis in patients with myelofibrosis syndrome (MDS) by intraosseous inoculation of demineralized bone matrix (DBM) together with allogeneic bone marrow cells (BMC).

Inclusion Criteria:

• Patients with impaired marrow stem cells by cytogenetic analysis or morphology (blasts), considered normal candidates for allogeneic BMT. Such patients will be also entitled for allogneic bone marrow transplantation with intraosseous DBM.
• Patients with documented myelofibrosis will be entitled for allogeneic bone marrow transplantation with intraosseous DBM.

Exclusion Criteria:

• Patients with anticipated life expectancy of <4 weeks.
• Pregnant or lactating women.
• Patients with an unrelated disease or relevant clinical problem that may not permit evaluation of the results of the study.
• Patients under 18 years old.