Bone Marrow Transplant Flashcards
How likely are siblings to be an exact match to each other
1/4
5 stages of autologous transplant
1 - GF injection -> stim stem cell growth
2- CD34+ (stem cell marker) cells collected from BM/ periph blood
3 - conditioning Tx (high dose chemo)
4 -re-infuse stem cells
5 - immune reconstitution
Timeline for acute GVHD
normally 2-3w after
but anything <100 days
Pathology of acute GVHD
conditioning Tx -> tissue damage -> APC activation -> donor T cell activation -> cellular / inflam markers
3 main organs affected in acute GVHD
skin - rash
liver - jaundice + hep
gut - diarrhoea
occurance of chronic GVHD
affects 50%
attack all organs
RF for GVHD
inc HLA disparity
intense conditioning
inc age
F donor (esp multiparous) to male pt
Tx for GVHD
corticosteroids
+/- ciclosporin a (calcineurin inhib)
prevention of GVHD
anyone getting a transplant given:
corticosteroids (methotrexate)
+ ciclosporin/tacrolimus