Clinical Blood and Marrow Transplant

Question 1

Which human leukocyte antigens must absolutely be matched in order to a transplant to be successful? (3 of them)

Answer 1

HLA-A
HLA-B
HLA-DR

Question 2

Why is an autologous transplant used in cancer therapy?

Answer 2

An autologous transplant involves a patients own bone marrow. It is removed from the patient, then intense radiation and chemo is done on the patient to attack cancer cells without worry of permanent damage to stem cells because the patient will just receive the marrow that was removed before the cancer treatment.

Termed: High Dose Therapy followed by Autologous Hematopoietic Stem Cell Rescue

Question 3

Complications of Autologous Transplant.

Answer 3

It takes time for the transplanted marrow stem cells to replenish the WBCs that were loss during the chemo or irradiation treatment. So areas normally high in WBCs (GI tract) become inflamed and patients get infections.
Mucositis (oral mucosa inflammation)
Nausea, Vomiting
Diarrhea

Question 4

What is the mechanism of graft rejection and a complication of preventing graft rejection?

Answer 4

Graft rejection occurs when donor tissue is recognized by recipient T cells and they are activated. This is prevented with immunosuppression. However, if the immune system is suppressed, there is a risk of Graft vs Host Disease where the graft’s immune system acts against he recipient.

Question 5

What is the major cause of tissue rejection in acute vs. chronic Graft vs. Host Disease?

Answer 5

Acute: inflammation
Chronic: fibrosis