Haematology 15 - Bone Marrow Transplant

Question 1

Which CD marker is expressed on haematopoietic stem cells?

Answer 1

CD34

Flow cytometry of ALL:
CD34 = precursor/stem cells
CD3, 4, 8 = T lymphocytes
CD19, 23 = B lymphocytes

Flow cytometry of AML
CD34 = precursor/stem cells
CD33, CD13, MPO = Myeloid
cells

Question 2

Recall the process of autologous transplant

Answer 2

1. Give G-CSF - lots of stem cells leak out into the blood
2. Freeze them (drop temp and store in liquid N2)
3. Patient has chemo/radio to permanently destroy their haematopietic system
4. Whip stem cells out of freezer and re-infuse

Question 3

What is autologous stem cell transplant used for?

Answer 3

To allow a higher dose of chemo/radio to be given

Myeloma/ lymphoma/ CLL

Question 4

Describe the process of allogeneic stem cell transplant

Answer 4

Give G-CSF to donor with normal BM
Treat patient with high-dise chemo and radio
Give patient harvested cells

Question 5

When should allogenic stem cell transplant be used?

Answer 5

Bone marrow failure

Any patient where bone marrow can’t be cleared (eg acute leukaemias)

Question 6

How is patient’s room pressure adjusted to prevent infection during BM transplant?

Answer 6

Make it a higher pressure than corridor so that air flows out rather than in

Question 7

Recall some principles of donor choice for a bone marrow transplant

Answer 7

1. HLA-matched

2. Ideally a sibling (1 in 4 chance of matching with each sibling)

Question 8

Which patients can receive umbilical cord blood cells?

Answer 8

Only children - as you can only harvest a small volume so patient needs to be of a low weight

Question 9

How many types of HLA are there?

Answer 9

> 20,000!