Bone Marrow Transplantation Flashcards
What is a BMT?
Transfer of bone marrow cells from one human to another.
What can a BMT treat?
Leukaemia. Immunodeficiency/anaemias.
How many BMT’s are performed in Europe per year?
Over 20,000
What is a serious complication of BMT?
Graft-versus-host disease.
Which cells are derived from cultures in bone marrow cells?
Haematopoietic Stem Cells (HSC)
What can HSC do?
HSTC can self-replicate and differentiate into ANY element of the blood.
How do HSC help in BMT?
They are harvested and re-infused to reconstitute damaged bone marrow.
Where else can HSC’s be found?
In small numbers in peripheral blood.
What are the sources for stem cell transplantation?
Patient (own cells), Matched sibling (25%), Matched unrelated donor (50%), Umbilical cord blood (restricted availability)
Which matched unrelated donor SC’s do the UK centres accept?
ATLEAST 9/10 match at HLA-A/B/B/DR/DQ. To reduce G-V-HD.
What is an autologous HSCT?
Transplanted cells have been taken from same patient previously from BM or peripheral blood.
What is an advantage of Autologous HSCT?
Less complicated as HLA is compatible.
What is a disadvantage of Autologous HSCT?
High dose of chemo and radiotherapy before transplant which irreversibly damages bone marrow.
Disadvantages of BMT Vs Cord blood
Pain and invasive surgical collection. BM dependent on donor participation. 60% G-V-HD rate.
Why does BMT require greater HLA match?
Maturity of the stem cells.
Advantages of cord blood?
Painless and non-invasive. No donor risk. Less expensive.
Why is GVHD reduced o 10% in cord blood donation?
There are no antibodies in the stem cells.
What is GVHD?
Immune cells from DONOR (T-Cells) attatch to recipient tissues. (gut/skin/liver)
What is Graft Vs Leukaemia effect?
When immunes T-cells from donor eliminate residual leukaemia cells in the recipient.
What is a Post-Transplant Chimerism Analysis?
Measurement of the level of engraftment post-surgery to indicate the outcome.
What is the level of PTCA for malignancies?
100% donor engraftment to prevent relapses.
What is the Level of PTCA for anaemias and enzyme deficiencies?
A mixed chimerism is enough to correct the disorder.
What is chimerism measured by?
STR= Short Tandem Repeat
